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March 16, 2001

Books:

• An Overview of Injury Research - Rivara
• Classifying and Counting Injury - Fingerhut & McLoughlin
• Measurement of Injury Severity and Co-morbidity - O'Keefe & Jurkovich
• Data Linkages and Using Administrative and Secondary Databases - Mueller
• Rates, Rate Denominators, and Rate Comparisons - Cummings
• Data Collection Methods - Runyan & Bowling
• Selecting a Study Design for Injury Research - Koepsell
• Qualitative Methods in Injury Research - Grossman & Rhodes
• Randomized Trials - Koepsell
• Cohort Studies in Injury Research - Kraus
• Case-Control Studies in Injury Research - Cummings, Koepsell, & Roberts
• Ecologic Studies Hingson, Howland, Koepsell, & Cummings
• Case Series and Trauma Registries - Mock
• Systematic Reviews of Injury Studies Bunn, DiGuiseppi, & Roberts
• Evaluating an Injury Intervention or Program - Thompson & Sacks
• The Development of Clinical Decision Rules for Injury Care - Stiell
• Trauma Performance Improvement - Maier & Rhodes
• Measuring Disability and Quality of Life Postinjury - MacKenzie
• Economic Evaluation of Injury Control - Grahan & Segui-Gomez
• Ethical Issues - McGough & Wolf

• Earthquake epidemiology: the 1994 Los Angeles Earthquake emergency department experience at a community hospital. Kazzi AA, Langdorf MI, Handly N, White K, Ellis K. Prehospital Disaster Med, 2000; 15(1):12-9
  
  INTRODUCTION: To assess the volume of patients and the composition of their injuries and illnesses that presented to an emergency department (ED) close to the epicenter of an earthquake that occurred in a seismically prepared area. METHODS: A retrospective analysis of data abstracted from charts and ED logs for patient census and types of injuries and illnesses of the patients who presented in the ED of a community hospital before and after the earthquake (6.8 Richter scale) that occurred in 1994 in Los Angeles. Illnesses were classified as trauma- and non-trauma related. Data were compared with epidemiological profiles of earthquakes in seismically prepared and unprepared areas. RESULTS: A statistically significant increase in ED patient census over baseline lasted 11 days. There was a large increase in the number of traumatic injuries such as lacerations and orthopedic injuries during the first 48 hours. Beginning on the third day after the event, primary care conditions predominated. When the effects of the LA quake were compared with those of similar Richter magnitude and disruptive capability, the ED epidemiology profile was similar to those in seismically unprepared areas, except for the total number of casualties. CONCLUSION: The majority of patients with traumatic injuries presented within the first 48 hours. The increase relative to baseline lasted 11 days. Efforts to develop disaster response systems from resources outside the disaster-stricken area should focus on providing mostly primary care assistance. Communities in seismically prepared areas could require external medical assistance for their EDs for up to two weeks following the event.



• Hospital responses to acute-onset disasters: a review. Milsten A. Prehospital Disaster Med, 2000; 15(1):32-45.
  
  INTRODUCTION: Hospitals the world over have been involved in disasters, both internal and external. These two types of disasters are independent, but not mutually exclusive. Internal disasters are isolated to the hospital and occur more frequently than do external disasters. External disasters affect the community as well as the hospital. This paper first focuses on common problems encountered during acute-onset disasters, with regards to hospital operations and caring for victims. Specific injury patterns commonly seen during natural disasters are reviewed. Second, lessons learned from these common problems and their application to hospital disaster plans are reviewed. METHODS: An extensive review of the available literature was conducted using the computerized databases Medline and Healthstar from 1977 through March 1999. Articles were selected if they contained information pertaining to a hospital response to a disaster situation or data on specific disaster injury patterns. Selected articles were read, abstracted, analyzed, and compiled. RESULTS: Hospitals continually have difficulties and failures in several major areas of operation during a disaster. Common problem areas identified include communication and power failures, water shortage and contamination, physical damage, hazardous material exposure, unorganized evacuations, and resource allocation shortages. CONCLUSIONS: Lessons learned from past disaster-related operational failures are compiled and reviewed. The importance and types of disaster planning are reviewed.

• Head injury in athletes. Bailes JE, Cantu RC. Neurosurgery 2001;48(1):26-45.
  
  Head injuries incurred during athletic endeavors have been recorded since games were first held. During the last century, our level of understanding of the types of cerebral insults, their causes, and their treatment has advanced significantly. Because of the extreme popularity of sports in the United States and worldwide, the implications of athletic head injury are enormous. This is especially true considering the current realization that mild traumatic brain injury (MTBI) or concussion represents a major health consideration with more long-ranging effects than previously thought. When considering athletic injuries, people who engage in organized sports, as well as the large number of people who engage in recreational activities, should be considered. There are 200 million international soccer players, a group increasingly recognized to be at risk for MTBI. The participation in contact sports of a large number of the population, especially youth, requires a careful and detailed analysis of injury trends and recommended treatment. There are numerous characteristics of this patient population that make management difficult, especially their implicit request to once again be subjected to potential MTBI by participating in contact sports. Recent research has better defined the epidemiological issues related to sports injuries involving the central nervous system and has also led to classification and management paradigms that help guide decisions regarding athletes' return to play. We currently have methods at our disposal that greatly assist us in managing this group of patients, including improved recognition of the clinical syndromes of MTBI, new testing such as neuropsychological assessment, radiographic evaluations, and a greater appreciation of the pathophysiology of concussive brain injury. The potential for long-term consequences of repetitive MTBI has been recognized, and we no longer consider the "dinged" states of athletic concussions to have the benign connotations they had in the past. We review the historical developments in the recognition and care of athletes with head injuries, the current theory of the pathophysiology and biomechanics of these insults, and the recommended management strategy, including return-to-play criteria.

• A sleep physiologist's view of the drowsy driver. Johns MW. Transportation Research Part F: Psychology and Behaviour 2000; 3(4):241-249.
  
  Drowsy driving is dangerous because of the impairment of driving skills that it causes. Unfortunately, the conceptual basis that underlies much of the multi-disciplinary research on this topic is muddled. The same poorly defined terms, such as fatigue and sleepiness, are used differently by different disciplines and researchers. Some new definitions and concepts are proposed here which may be helpful, as least as a stimulus for discussion by others. Drowsiness, sleepiness and fatigue are distinguished. A new conceptual model of sleepiness is outlined, based on a mutually inhibitory interaction between a putative sleep drive and a wake drive. Sleepiness, defined as sleep propensity, is a function of the relative strengths, not the absolute strengths, of the sleep and wake drives. The measurement of sleepiness requires some new variables such as instantaneous sleep propensity, to be distinguished from either the situational or the average sleep propensity. A subject's instantaneous sleep propensity depends on many variables including his average sleep propensity in daily life, the time of day, the duration of prior wakefulness, the subject's posture, physical and mental activity at the time, and individual differences based on psychophysiological traits. The relationship between dozing at the wheel while driving and crashing the vehicle may not be as straightforward as it appears at first.



• Phantom Taxi Belts. Welkon C. Reisnger KS. J Trffic Med 1978; 6(4):50.
  
  Passengers in taxis are generally denied access to safety belts. We observed the accessibility of safety belts in 337 taxis in four metropolitan airports in the USA. In 85 percent of the taxis the belts were "apparitional" -- one half in view and the other half buried in the seat. Many of the taxi drivers interviewed said that the belts fall behind the seats as the result of day-to-day use, but some said that company mechanics purposely displace the belts during the cab's initial inspection after delivery.

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