Suchergebnisse

In urban China, mortality from injuries has increased over the past five decades. By contrast, life expectancy has continued to increase and has come to nearly equal life expectancy in developed countries. Currently, most of the life expectancy lost due to injury (65%) in urban China would be recovered if injury rates were the same as in countries with low injury-related mortality. Fundamentally, the rising trend in urban injury mortality in China reflects a continued focus on injury treatment rather than prevention in the face of fast socioeconomic development and increasing exposure to risk factors for injury. Despite improved injury prevention legislation and a 'Safe Community' campaign, urban China needs to modify its approach to urban injury management and focus on prevention. The gap between urban China and countries with low injury mortality can be closed by means of legislation, strengthened law enforcement and the establishment of safer communities. Risks affecting children and migrants deserve greater attention, and the government needs to allocate more resources to injury prevention to mid-western urban areas in particular. Based on the population size of urban China, measures for the prevention of injury mortality would save an annual 436.4 million years of life.

This study examined profiles of specific emotion deficits, including poor emotion awareness, reluctance to express emotion, sadness inhibition and dysregulation, and anger inhibition and dysregulation. Self‐report questionnaires assessed adolescents' emotion skills and nonsuicidal self‐injury (NSSI) engagement, frequency, severity, methods, and age of onset. Latent profile analysis yielded a three‐profile solution: Low Deficit (LD; n = 49), Unaware/Anger Dysregulated (UAD; n = 24), and Anger Inhibited (AI; n = 20) profiles. Adolescents in the UAD profile were more likely to engage in NSSI, displayed a higher NSSI frequency, and reported a higher number of NSSI methods when compared to adolescents in the LD profile. No links emerged for NSSI severity or age of onset.

STUDY DESIGN: Systematic review. OBJECTIVES: War-related spinal cord injuries (SCIs) are commonly more severe and complex than traumatic SCIs among civilians. This systematic review, for the first time, synthesized and critically appraised the literature on the epidemiology of war-related SCIs. This review aimed to identify distinct features from the civilian SCIs that can have an impact on the management of military and civilian SCIs. METHODS: Medline, EMBASE, and PsycINFO databases were searched for articles on epidemiology of war-related SCI among combatants, published from 1946 to December 20, 2017. This review included only original publications on epidemiological aspects of SCIs that occur during an act of war. The STROBE statement was used to examine the quality of the publications. RESULTS: The literature search identified 1594 publications, of which 25 articles fulfilled the inclusion and exclusion criteria. The studies were classified into the following topics: 17 articles reported demographics, level and severity of SCI, mechanism of injury and/or associated bodily injuries; 5 articles reported the incidence of war-related SCI; and 6 articles reported the frequency of SCI among other war-related bodily injuries. Overall, military personnel with war-related SCI were typically young, white men, with predominantly thoracic or lumbar level, complete (American Spinal Injury Association [ASIA] Impairment Scale A) SCI due to gunshot or explosion and often associated with other bodily injuries. Marines appear to be at a greater risk of war-related SCI than the military personal in the Army, Navy, and Air Force. CONCLUSIONS: The war-related SCIs among soldiers are distinct from the traumatic SCI in the general population. The majority of the current literature is based on the American experiences in most recent wars.

Purpose
Brain Injury Case Managers (BICMs) work closely with individuals with Acquired Brain Injury (ABI), assessing needs, structuring rehabilitation interventions and providing support, and have significant experience of clients with impairments to decision making. The purpose of this paper is to explore the application of the Mental Capacity Act (MCA) and its guidance when applied to ABI survivors. This research aimed to: first, highlight potential conflicts or tensions that application of the MCA might pose, and second, identify approaches to mitigate the problems of the MCA and capacity assessments with ABI survivors. It is hoped that this will support improvements in the services offered.


Design/methodology/approach
Using a mixed method approach, 93 BICMs responded to an online questionnaire about decision making following ABI. Of these, 12 BICMs agreed to take part in a follow-up semi-structured telephone interview.


Findings
The data revealed four main themes: disagreements with other professionals, hidden disabilities, vulnerability in the community and implementation of the MCA and capacity assessments.


Practical implications
The findings highlight the need for changes to the way mental capacity assessments are conducted and the need for training for professionals in the hidden effects of ABI.


Originality/value
Limited research exists on potential limitations of the application of the MCA for individuals with an ABI. This paper provides much needed research on the difficulties surrounding mental capacity and ABI.

OBJECTIVE. The purpose of this study was to identify the needs of military service members with chronic symptoms after mild traumatic brain injury (mTBI) that fall within the scope of occupational therapy practice. METHOD. In this qualitative descriptive study, service members with a history of mTBI (N = 12) participated in semistructured interviews about their injury history, symptoms, daily routines, challenges, and plans. RESULTS. Two main themes were identified: occupational changes and plans for the future. Occupational changes contains six subthemes: (1) rest and sleep, (2) activities of daily living and instrumental activities of daily living, (3) work, (4) social participation, (5) play and leisure, and (6) education. Plans for the future contains three subthemes: (1) supports, (2) barriers, and (3) fears. CONCLUSION. Occupational therapists who work with this population should consider all areas of occupation, especially sleep, during assessment and treatment planning. Some clients may require additional support for preparing for civilian life.

ABSTRACTAmong the various sequelae associated with the treatment of oral carcinoma (both surgical and radiotherapy), the two conditions that can be of serious concern are reduced mouth opening and mucositis. The limited mouth opening can lead to entrapment of buccal mucosa in between teeth during the chewing cycle, which in turn can lead to further injury of the mucosa. A simple method has been described by the authors to prevent the cheek bite by fabrication of a cheek guard appliance. Favorable results were seen within a few days after insertion of the appliance.

School mental health specialists understand suicide and self-injury among students is a significant and growing concern. This new reality will take a school-wide approach to suicide prevention where school mental health specialists develop and lead a school-wide culture of care. Featuring over 120 research-backed strategies, this book provides readerw with step-by-step approaches and a research-informed, practical strategy for how schools can develop and implement a systemic and realistic school-wide approach. All staff, teachers, students, and parents have a role to play in saving lives; suicide prevention truly becomes a shared responsibility in which this book can be a vital tool.

The extent to which English law remedies injury to autonomy (ITA) as a stand-alone actionable damage in negligence is disputed. In this article I argue that the remedy available is not only partial and inconsistent (Keren-Paz in Med Law Rev, 2018) but also gendered and discriminatory against women. I first situate the argument within the broader feminist critique of tort law as failing to appropriately remedy gendered harms, and of law more broadly as undervaluing women's interest in reproductive autonomy. I then show by reference to English remedies law's first principles how imposed motherhood cases—Rees v Darlington and its predecessor McFarlane v Tayside Health Board—result in gender injustice when compared with other autonomy cases such as Chester v Afshar and Yearworth v North Bristol NHS Trust: A minor gender-neutral ITA is better remedied than the significant gendered harm of imposing motherhood on the claimant; men's reproductive autonomy is protected to a greater extent than women's; women's reproductive autonomy is protected by an exceptional, derisory award. Worst of all, courts refuse to recognise imposed motherhood as detriment; and the deemed, mansplained, nonpecuniary joys of motherhood are used to offset pecuniary upkeep costs, forcing the claimant into a position she sought to avoid and thus further undermining her autonomy. The recent Singaporean case ACB v Thomson Medical Pte Ltd, awarding compensation for undermining the claimant's genetic affinity in an IVF wrong-sperm-mix-up demonstrates some improvement in comparison to English law, and some shared gender injustices in the context of reproductive autonomy. ACB's analysis is oblivious to the nature of reproductive autonomy harm as gendered; and prioritises the father's interest in having genetic affinity with the baby over a woman's interest in not having motherhood imposed upon her.

IntroductionMusculoskeletal injuries are common during military and other occupational physical training programs. Employers have a duty of care to reduce employees' injury risk, where females tend to be at greater risk than males. However, quantification of principle co-factors influencing the sex–injury association, and their relative importance, remain poorly defined. Injury risk co-factors were investigated during Royal Air Force (RAF) recruit training to inform the strategic prioritization of mitigation strategies.Material and MethodsA cohort of 1,193 (males n = 990 (83%); females n = 203 (17%)) recruits, undertaking Phase-1 military training, were prospectively monitored for injury occurrence. The primary independent variable was sex, and potential confounders (fitness, smoking, anthropometric measures, education attainment) were assessed pre-training. Generalized linear models were used to assess associations between sex and injury.ResultsIn total, 31% of recruits (28% males; 49% females) presented at least one injury during training. Females had a two-fold greater unadjusted risk of injury during training than males (RR = 1.77; 95% CI 1.49–2.10). After anthropometric, lifestyle and education measures were included in the model, the excess risk decreased by 34%, but the associations continued to be statistically significant. In contrast, when aerobic fitness was adjusted, an inverse association was identified; the injury risk was 40% lower in females compared with males (RR = 0.59; 95% CI: 0.42–0.83).ConclusionsPhysical fitness was the most important confounder with respect to differences in males' and females' injury risk, rather than sex alone. Mitigation to reduce this risk should, therefore, focus upon physical training, complemented by healthy lifestyle interventions.