Suchergebnisse

This article offers a consideration of the gendered emotion of "shame" within the context of the lived experiences of spinal cord injured men, using "found life histories" as a source material. Drawing upon the Bourdieusian concept of "hysteresis," I theorize the emergence of a gendered disjuncture between incorporated expectations, values and assumptions, and the substantive enactments of masculinity socially available in the aftermath of spinal cord injury. Shame was often experienced within contexts characterized by "dangerous" social proximity to pathologized "others" (namely, disabled people and children) against which hegemonic masculinity is defined. I conclude the article by highlighting the particular limitations that Bourdieusian social theory can be used to identify in relation to individualized therapeutic interventions designed to encourage spinal cord injured men to adopt new understandings of masculinity.

In this article, we examine the representational practices of British newspapers in relation to forms of military injury. Using critical discourse analysis, we studied the reporting of injuries sustained by military personnel during the height of the UK's war in Afghanistan in 2009 – and a comparison period five years later – and concluded that representations of injured personnel differed substantially between articles reporting on 'combat' and 'non-combat' injuries. We argue that the different reporting frames work to construct a moral separation of injuries into 'heroic' (combat) and 'non-heroic' (non-combat) forms. The consequences of this hierarchisation of injury, we suggest, include the reification of 'combat' as an idealized form of masculine violence, the privileging of some soldiers and veterans over others as exemplars of national heroism, and elision of the day-to-day realities of military injury from public consciousness. Findings are discussed in relation to broader consequences for understanding heroism and the military.

Traumatic brain injury (TBI) is a significant public health burden, and the development of advanced countermeasures to mitigate and prevent these injuries during automotive, sports, and military impact events requires an understanding of the intracranial mechanisms related to TBI. In this study, the efficacy of tissue-level injury metrics for predicting TBI was evaluated using finite element reconstructions from a comprehensive, multi-species TBI database. The database consisted of human volunteer tests, laboratory-reconstructed head impacts from sports, in vivo non-human primate (NHP) tests, and in vivo pig tests. Eight tissue-level metrics related to brain tissue strain, axonal strain, and strain-rate were evaluated using survival analysis for predicting mild and severe TBI risk. The correlation between TBI risk and most of the assessed metrics were statistically significant, but when injury data was analyzed by species, the best metric was often inconclusive and limited by the small datasets. When the human and animal datasets were combined, the injury analysis was able to delineate maximum axonal strain as the best predictor of injury for all species and TBI severities, with maximum principal strain as a suitable alternative metric. The current study is the first to provide evidence to support the assumption that brain strain response between human, pig, and NHP result in similar injury outcomes through a multi-species analysis. This assumption is the biomechanical foundation for translating animal brain injury findings to humans. The findings in the study provide fundamental guidelines for developing injury criteria that would contribute towards the innovation of more effective safety countermeasures.

Background Traumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury. Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016 to measure the global, regional, and national burden of TBI and SCI by age and sex. We measured the incidence and prevalence of all causes of injury requiring medical care in inpatient and outpatient records, literature studies, and survey data. By use of clinical record data, we estimated the proportion of each cause of injury that required medical care that would result in TBI or SCI being considered as the nature of injury. We used literature studies to establish standardised mortality ratios and applied differential equations to convert incidence to prevalence of long-term disability. Finally, we applied GBD disability weights to calculate YLDs. We used a Bayesian meta-regression tool for epidemiological modelling, used causespecific mortality rates for non-fatal estimation, and adjusted our results for disability experienced with comorbid conditions. We also analysed results on the basis of the Socio-demographic Index, a compound measure of income per capita, education, and fertility. Findings In 2016, there were 27.08 million (95% uncertainty interval [UI] 24.30-30.30 million) new cases of TBI and 0.93 million (0.78-1.16 million) new cases of SCI, with age-standardised incidence rates of 369 (331-412) per 100 000 population for TBI and 13 (11-16) per 100 000 for SCI. In 2016, the number of prevalent cases of TBI was 55.50 million (53.40-57.62 million) and of SCI was 27.04 million (24.98-30.15 million). From 1990 to 2016, the agestandardised prevalence of TBI increased by 8.4% (95% UI 7.7 to 9.2), whereas that of SCI did not change significantly (-0.2% [-2.1 to 2.7]). Age-standardised incidence rates increased by 3.6% (1.8 to 5.5) for TBI, but did not change significantly for SCI (-3.6% [-7.4 to 4.0]). TBI caused 8.1 million (95% UI 6.0-10.4 million) YLDs and SCI caused 9.5 million (6.7-12.4 million) YLDs in 2016, corresponding to age-standardised rates of 111 (82-141) per 100 000 for TBI and 130 (90-170) per 100 000 for SCI. Falls and road injuries were the leading causes of new cases of TBI and SCI in most regions. Interpretation TBI and SCI constitute a considerable portion of the global injury burden and are caused primarily by falls and road injuries. The increase in incidence of TBI over time might continue in view of increases in population density, population ageing, and increasing use of motor vehicles, motorcycles, and bicycles. The number of individuals living with SCI is expected to increase in view of population growth, which is concerning because of the specialised care that people with SCI can require. Our study was limited by data sparsity in some regions, and it will be important to invest greater resources in collection of data for TBI and SCI to improve the accuracy of future assessments. ; Published version ; We acknowledge the funding and support of the Bill & Melinda Gates Foundation. AK was supported by the Miguel Servet contract, which was financed by the CP13/00150 and PI15/00862 projects integrated into the National Research, Development, and Implementation, and funded by the Instituto de Salud Carlos III General Branch Evaluation and Promotion of Health Research and the European Regional Development Fund (ERDF-FEDER). AMS is supported by the Egyptian Fulbright Mission Program. AF acknowledges the Federal University of Sergipe (Sergipe, Brazil). AA received financial assistance from the Indian Department of Science and Technology (New Delhi, India) through the INSPIRE faculty programme. AS is supported by Health Data Research UK. DJS is supported by the South African Medical Research Council. AB is supported by the Public Health Agency of Canada. SMSI received a senior research fellowship from the Institute for Physical Activity and Nutrition, Deakin University (Waurn Ponds, VIC, Australia), and a career transition grant from the High Blood Pressure Research Council of Australia. FP and CF acknowledge support from the European Union (FEDER funds POCI/01/0145/FEDER/007728 and POCI/01/0145/FEDER/007265) and National Funds (FCT/MEC, Fundação para a Ciência e a Tecnologia, and Ministério da Educação e Ciência) under the Partnership Agreements PT2020 UID/MULTI/04378/2013 and PT2020 UID/QUI/50006/2013. TB acknowledges financial support from the Institute of Medical Research and Medicinal Plant Studies, Yaoundé, Cameroon. AM of Imperial College London is grateful for support from the Northwest London National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care and the Imperial NIHR Biomedical Research Centre. KD is funded by a Wellcome Trust Intermediate Fellowship in Public Health and Tropical Medicine (grant number 201900). PSA is supported by an Australian National Health and Medical Research Council Early Career Fellowship. RT-S was supported in part by grant number PROMETEOII/2015/021 from Generalitat Valenciana and the national grant PI17/00719 from ISCIII-FEDER. The Serbian part of this contribution (by MJ) has been co-financed with grant OI175014 from the Serbian Ministry of Education, Science and Technological Development; publication of results was not contingent upon the Ministry's approval. MMMSM acknowledges support from the Serbian Ministry of Education, Science and Technological Development (contract 175087). MM's research was supported by the NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust (London, UK) and King's College London. The views expressed are those of the authors and not necessarily those of the UK National Health Service, the NIHR, or the UK Department of Health. TWB was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt professor award, which was funded by the German Federal Ministry of Education and Research.

OBJECTIVE--To examine the risk of injury to the head and the effect of wearing helmets in bicycle accidents among children. DESIGN--Case-control study by questionnaire completed by the children and their carers. SETTING--Two large children's hospitals in Brisbane, Australia. SUBJECT--445 children presenting with bicycle related injuries during 15 April 1991 to 30 June 1992. The cases comprised 102 children who had sustained injury to the upper head including the skull, forehead and scalp or loss of consciousness. The controls were 278 cyclists presenting with injuries other than to the head or face. A further 65 children with injuries to the face were considered as an extra comparison group. MAIN OUTCOME MEASURES--Cause and type of injury, wearing of helmet. RESULTS--Most children (230) were injured after losing control and falling from their bicycle. Only 31 had contact with another moving vehicle. Children with head injury were significantly more likely to have made contact with a moving vehicle than control children (19 (19%) v 12 (4%), P < 0.001). Head injuries were more likely to occur on paved surfaces than on grass, gravel, or dirt. Wearing a helmet reduced the risk of head injury by 63% (95% confidence interval 34% to 80%) and of loss of consciousness by 86% (62% to 95%). CONCLUSIONS--The risk of head injury in bicycle accidents is reduced among children wearing a helmet. Current helmet design maximises protection in the type of accident most commonly occurring in this study. Legislation enforcing helmet use among children should be considered.

Funding Information: We are deeply indebted to Marita Suni, RN, for caring for the very prematurely born infants during the MEG measurements. We also express our gratitude to all our subjects and their families for preparing the way for this study. Finally, we thank the personnel of the maternity ward of the Department of Obstetrics and Gynecology and the Neonatal Intensive Care Unit at the Helsinki University Hospital and the neonatal ward at Jorvi Hospital for their cooperation. This study was supported by Päivikki and Sakari Sohlberg Foundation (to K.R.), Foundation for Pediatric Research in Finland (to K.R., M.M., S.A.), Governmental Subsidy to Clinical Research (to S.A.), Finska Läkaresällskapet (to S.A.), and Arvo and Lea Ylppö Foundation (to A.L.). The funding sources did not participate in the work. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved. ; Background: Extremely low gestational age newborns (ELGANs) are at risk of neurodevelopmental impairments that may originate in early NICU care. We hypothesized that early oxygen saturations (SpO2), arterial pO2 levels, and supplemental oxygen (FiO2) would associate with later neuroanatomic changes. Methods: SpO2, arterial blood gases, and FiO2 from 73 ELGANs (GA 26.4 ± 1.2; BW 867 ± 179 g) during the first 3 postnatal days were correlated with later white matter injury (WM, MRI, n = 69), secondary cortical somatosensory processing in magnetoencephalography (MEG-SII, n = 39), Hempel neurological examination (n = 66), and developmental quotients of Griffiths Mental Developmental Scales (GMDS, n = 58). Results: The ELGANs with later WM abnormalities exhibited lower SpO2 and pO2 levels, and higher FiO2 need during the first 3 days than those with normal WM. They also had higher pCO2 values. The infants with abnormal MEG-SII showed opposite findings, i.e., displayed higher SpO2 and pO2 levels and lower FiO2 need,than those with better outcomes. Severe WM changes and abnormal MEG-SII were correlated with adverse neurodevelopment. Conclusions: Low oxygen levels and high FiO2 need during the NICU care associate with WM abnormalities, whereas higher oxygen levels correlate with abnormal MEG-SII. The results may indicate certain brain structures being more vulnerable to hypoxia and others to hyperoxia, thus emphasizing the role of strict saturation targets. Impact: This study indicates that both abnormally low and high oxygen levels during early NICU care are harmful for later neurodevelopmental outcomes in preterm neonates.Specific brain structures seem to be vulnerable to low and others to high oxygen levels.The findings may have clinical implications as oxygen is one of the most common therapies given in NICUs.The results emphasize the role of strict saturation targets during the early postnatal period in preterm infants. ; Peer reviewed