Outcomes and costs of blunt trauma in England and Wales

Background Trauma represents an important public health concern in the United Kingdom, yet the acute costs of blunt trauma injury have not been documented and analysed in detail. Knowledge of the overall costs of trauma care, and the drivers of these costs, is a prerequisite for a cost-conscious approach to improvement in standards of trauma care, including evaluation of the cost-effectiveness of new healthcare technologies. Methods Using the Trauma Audit Research Network database, we examined patient records for persons aged 18 years and older hospitalised for blunt trauma between January 2000 and December 2005. Patients were stratified by the Injury Severity Score (ISS). Results A total of 35,564 patients were identified; 60% with an ISS of 0 to 9, 17% with an ISS of 10 to 16, 12% with an ISS of 17 to 25, and 11% with an ISS of 26 to 75. The median age was 46 years and 63% of patients were men. Falls were the most common cause of injury (50%), followed by road traffic collisions (33%). Twenty-nine percent of patients were admitted to critical care for a median length of stay of 4 days. The median total hospital length of stay was 9 days, and 69% of patients underwent at least one surgical procedure. Seven percent of the patients died before discharge, with the highest proportion of deaths among those in the ISS 26–75 group (32%). The mean hospital cost per person was £9,530 (± 11,872). Costs varied significantly by Glasgow Coma Score, ISS, age, cause of injury, type of injury, hospital mortality, grade and specialty of doctor seen in the accident and emergency department, and year of admission. Conclusion The acute treatment costs of blunt trauma in England and Wales vary significantly by injury severity and survival, and public health initiatives that aim to reduce both the incidence and severity of blunt trauma are likely to produce significant savings in acute trauma care. The largest component of acute hospital cost is determined by the length of stay, and measures designed to reduce length of admissions are likely to be the most effective in reducing the costs of blunt trauma care

Outcomes and costs of penetrating trauma injury in England and Wales

The official published version of the article can be found at the link below.Background: Penetrating trauma injury is generally associated with higher short-term mortality than blunt trauma, and results in substantial societal costs given the young age of those typically injured. Little information exists on the patient and treatment characteristics for penetrating trauma in England and Wales, and the acute outcomes and costs of care have not been documented and analysed in detail.Methods: Using the Trauma Audit Research Network (TARN) database, we examined patient records for persons aged 18+ years hospitalised for penetrating trauma injury between January 2000 and December 2005. Patients were stratified by injury severity score (ISS).Results: 1365 patients were identified; 16% with ISS 1-8, 50% ISS 9-15, 15% ISS 16-24, 16% ISS 25-34, and 4% with ISS 35-75. The median age was 30 years and 91% of patients were men. Over 90% of the injuries occurred in alleged assaults. Stabbings were the most common cause of injury (73%), followed by shootings (19%). Forty-seven percent were admitted to critical care for a median length of stay of 2 days; median total hospital length of stay was 7 days. Sixty-nine percent of patients underwent at least one surgical procedure. Eight percent of the patients died before discharge, with a mean time to death of 1.6 days (S.D. 4.0). Mortality ranged from 0% among patients with ISS 1-8 to 55% in patients with ISS > 34. The mean hospital cost per patient was 7983 pound, ranging from 6035 pound in patients with ISS 9-15 to El 6,438 among patients with ISS > 34. Costs varied significantly by ISS, hospital mortality, cause and body region of injury.Conclusion: The acute treatment costs of penetrating trauma injury in England and Wales vary by patient, injury and treatment characteristics. Measures designed toreduce the incidence and severity of penetrating trauma may result in significant hospital cost savings. (C) 2008 Elsevier Ltd. All rights reserved.This study was funded by Novo Nordisk A/S

An interface to virtual environments for people who are blind using Wii technology - mental models and navigation

Accessible games, both for serious and for entertainment purposes, would allow inclusion and participation for those with disabilities. Research into the development of accessible games, and accessible virtual environments, is discussed. Research into accessible Virtual Environments has demonstrated great potential for allowing people who are blind to explore new spaces, reducing their reliance on guides, and aiding development of more efficient spatial maps and strategies. Importantly, Lahav and Mioduser (2005, 2008) have demonstrated that, when exploring virtual spaces, people who are blind use more and different strategies than when exploring real physical spaces, and develop relatively accurate spatial representations of them. The present paper describes the design, development and evaluation of a system in which a virtual environment may be explored by people who are blind using Nintendo Wii devices, with auditory and haptic feedback. The nature of the various types of feedback is considered, with the aim of creating an intuitive and usable system. Using Wii technology has many advantages, not least of which are that it is mainstream, readily available and cheap. The potential of the system for exploration and navigation is demonstrated. Results strongly support the possibilities of the system for facilitating and supporting the construction of cognitive maps and spatial strategies. Intelligent support is discussed. Systems such as the present one will facilitate the development of accessible games, and thus enable Universal Design and accessible interactive technology to become more accepted and widespread

First year student experience

The application was made on behalf of the undergraduate courses team who sought to enhance the first year experience by engaging students in the practice of business. The intention was to develop and signpost enterprising qualities and characteristics in first year learners and develop confidence as well as competence. The undergraduate review for FBL commenced in September 2009. This offered an opportunity to innovate and build good practice in enterprise learning as a pilot to inform the undergraduate review. The team sought to provide a coherent and relevant set of learning experiences that could be achieved outside structured curriculum that would enable learning through live projects

A study of client characteristics and worker methods, that may be related to early unplanned termination in family service clients with marital problems

Thesis (M.S.)--Boston Universit

Nuclear Spirals in the inner Milky Way

We use hydrodynamical simulations to construct a new coherent picture for the gas flow in the Central Molecular Zone (CMZ), the region of our Galaxy within $R\leq 500\, \mathrm{pc}$. We relate connected structures observed in $(l,b,v)$ data cubes of molecular tracers to nuclear spiral arms. These arise naturally in hydrodynamical simulations of barred galaxies, and are similar to those that can be seen in external galaxies such as NGC4303 or NGC1097. We discuss a face-on view of the CMZ including the position of several prominent molecular clouds, such as Sgr B2, the $20\,{\rm km\, s^{-1}}$ and $50\,{\rm km\, s^{-1}}$ clouds, the polar arc, Bania Clump 2 and Sgr C. Our model is also consistent with the larger scale gas flow, up to $R\simeq 3\,\rm kpc$, thus providing a consistent picture of the entire Galactic bar region.Comment: Accepted for publication in MNRAS, 12 pages, 12 figure

Evaluation of Giga-bit Ethernet Instrumentation for SalSA Electronics Readout (GEISER)

An instrumentation prototype for acquiring high-speed transient data from an array of high bandwidth antennas is presented. Multi-kilometer cable runs complicate acquisition of such large bandwidth radio signals from an extensive antenna array. Solutions using analog fiber optic links are being explored, though are very expensive. We propose an inexpensive solution that allows for individual operation of each antenna element, operating at potentially high local self-trigger rates. Digitized data packets are transmitted to the surface via commercially available Giga-bit Ethernet hardware. Events are then reconstructed on a computer farm by sorting the received packets using standard networking gear, eliminating the need for custom, very high-speed trigger hardware. Such a system is completely scalable and leverages the hugh capital investment made by the telecommunications industry. Test results from a demonstration prototype are presented.Comment: 8 pages, to be submitted to NIM