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This article explores social epidemiological issues in the morbidity of psychiatric dysfunction, and in the mortality associated with socioenvironmental stress in Cuba. It builds on a review of the contribution of factors such as social status and social integration or marginality in a revolutionary society. This article explores relevant issues in the epidemiology of heart disease, cirrhosis of the liver, accidents, homicide, and suicide mortality. The review suggests a pattern of increasing epidemiological costs that seem to implicate the Island's process of social and economic development. These costs are contrasted to marked benefits in several domains, which appear to respond to economic democracy, and to effective planning and policy development. [ABSTRACT FROM AUTHOR]

The primary causes of rapidly increasing auto bodily injury insurance rates in the late 1980s and early 1990s are an increase in the number of claims filed per accident and the escalation of medical costs at twice the overall rate of inflation. Changes in claiming behavior can arise from the operation of a personal injury insurance lottery. Claimants, perhaps assisted by a lottery "manager," make behavioral choices to incur the monetary and psychic costs of filing a fraudulent or exaggerated claim for the payment of general (noneconomic) damages as the lottery payoff. This article provides operational meaning to the personal injury lottery and evidence of its existence under the Massachusetts no-fault system with a monetary threshold for tort claims. A random sample of claims arising from 1989 Massachusetts accidents is used to identify claims for simple soft-tissue strain and sprain injuries as the likely conduit for lottery-type claims. The cost/benefit effectiveness of specialized claim handling techniques employed by insurers to expose and reduce lottery claims is explored through a model of the total auto insurance compensation. [ABSTRACT FROM AUTHOR]

Following Cooper and Ross (1985), this article contributes to the literature by developing a principal-agent approach to the effect of imperfect information on safety in the workplace. Firms and workers can influence the probability of workplace accidents by taking precautions. To the extent that a worker's precaution cannot be observed by a firm, and vice versa, contract designing is a problem characterized by moral hazard. Double and single moral hazard lead to nonoptimal levels of precaution from firms and workers, but not necessarily to an underprovision of precaution. Furthermore, it is shown that regulatory policies aimed at promoting safety in ,the workplace (by inducing increases in the levels of precaution) may not be welfare-improving. [ABSTRACT FROM AUTHOR]

While flooding or direct therapeutic exposure (DTE) has been empirically validated as an effective primary treatment for PTSD through several randomized controlled trials, there is also evidence that relatively few trauma therapists actually use the technique. There are now several published reports which document a number of the difficulties in implementing the treatment with chronic PTSD patients. These problems, ranging from patient refusal to adverse reactions, represent several domains, including trauma history characteristics, patients' personal characteristics, therapist factors, and treatment environment factors. The purpose of the present report is to provide an empirical rationale to support the use of individual flooding as a primary form of psychotherapy for chronic combat-related PTSD. Implementation rates for flooding are compared among expert behavioural trauma therapists versus field use rates for trauma programmes generally. Complications or side-effects of flooding are considered. We also identify several predictable sources of difficulty in implementing individual flooding and the proportions of patients likely to be affected by each type. Finally, practical suggestions are offered for improving utilization of flooding, and directions for future empirical investigations are explored. [ABSTRACT FROM AUTHOR]

A major investigation in the North West region has aimed to ascertain attitudes towards, and expectations of, accident and emergency services among both client groups and professionals involved in the provision of the services. One element of the research has focussed on a questionnaire based survey among 260 nurses in nineteen hospital accident and emergency (A & E) departments. The results show that the nurses found their work to be interesting and satisfying and they enjoyed the challenge of a varied and unpredictable workload. They expected to deal with patients in need of urgent medical attention, and to use and develop their nursing skills and experience. On the whole, their expectations were met, although they were not very satisfied with the levels of cooperation from other hospital departments, their liaison with community services, and the amount of time which casual attenders with minor/non-urgent conditions occupied. The nurses were, however, generally sympathetic towards all A & E patients although they believed that many came for reasons of convenience and ignorance and that the general public need more education with regard to the appropriate use of an A & E department. [ABSTRACT FROM AUTHOR]

The article discusses against the question of cycle helmets for children. While the majority of minor and moderate accidents occur when the cyclist is alone, 85-90% of fatal and serious injuries are through collisions with vehicles. Analysis of the value of protection against injuries therefore needs to take the severity of the injuries into account. As routine statistical information systems do not record severity reliably, special studies are necessary. The study, from Brisbane, Australia, compared children with head injuries from bicycle accidents with children with other cycling accident injuries and the differential use of cycle helmets was recorded.

Process analysis, as described in this article, is a behavioral, fine-grained, specific, prospective method of examining both injury and near-injury situations. By analyzing the antecedents, stages of response, and consequences of injury risk situations, process analysis may improve scientists' conceptualization of injury situations. It can also provide additional methods of evaluating ongoing intervention strategies and suggest new, more appropriate modes of intervention. Process analysis is particularly well-suited to analyzing person-based interventions. Some examples of such a complementary assessment system and a discussion of its advantages are presented. [ABSTRACT FROM AUTHOR]

This is an ecological test of adaptation in head-injured adults, reporting reliability and validity of the Executive Function Route-finding Task (EFRT: Boyd and Sautter, 1985). A Likert scale was used to rate executive aspects of route-finding such as task formulation, strategy of approach, detection and correction of errors, and dependence on cueing among 31 head-injured young adults within a large rehabilitation facility. The Task has high inter-rater reliability and acceptable concurrent validity with other neuropsychological constructs. [ABSTRACT FROM AUTHOR]

This research compares memory for traumatic events with memory for non-traumatic versions of the same event. In Experiment 1, subjects watched an event depicted in slides while focusing and rehearsing the central detail of each slide. They were tested after a short or a longer retention interval (20 mm or 2 weeks). Subjects who watched the traumatic version were better able to recall the central details that they had rehearsed, but were less well able to recognize the specific slides that they saw. Better recall for the traumatic group did not occur because the words used to describe the recalled details were inherently more memorable, as shown in Experiment 2. In Experiment 3, subjects watched either a traumatic or non-traumatic version of a filmed event and about 6 months later they were asked to remember the essence of the film. Subjects who saw the traumatic version were better able to recall the essence of the film. A similar finding was obtained with a group of subjects from Experiment 1 who were also contacted about 6 months alter their initial participation. These results suggest that some information (the essence, the theme) of a traumatic event might be relatively well retained in memory, white memory is impaired for many of the specific, and especially peripheral, details. [ABSTRACT FROM AUTHOR]

The article presents information on the working of the Royal Commissions on Environmental Pollution in Great Britain. The Royal Commission was established in 1969 amidst growing public unease over pollution. Coastal oil spillages, the sea bird " wreck in the Irish Sea, and international disasters such as the 40 million fish killed by endosulfan pollution in the Rhine were just some of a number of pollution incidents that caused widespread public concern. Pollution was in danger of becoming a political issue.

Analyzes the issue of fire fatalities in the United States. Causes of fire fatalities; Age range of fire victims; Areas with highest and lowest fire fatality rates; Enforcement of the building and housing codes; Promotion of smoke alarms.

Previous research has explored the domain of legal and educational prevention in regard to the phenomena of accidents and injuries caused by drinking and driving. Most investigations of psychological factors attempt to distinguish characteristics of drunk drivers relative to the general driving population or controls matched on driving risk variables. In contrast, the present research concentrated on the examination of the process by which empirically derived personality and general attitudinal constructs operate within a cognitive framework to influence the decision to drive. Four conceptual models were proposed that suggested the presence of direct, indirect, and moderated effects of personality and general attitudinal constructs on cognitions relevant to drunk-driving tendencies. Support was observed for a model suggesting the presence of indirect, direct, and moderating effects for the general attitudinal construct driving aggression, and support for an indirect effects model for the personality variable emotional control. The implications of these findings are discussed in the context of utilizing personality and general attitudinal constructs to improve short term cognitive-based interventions. [ABSTRACT FROM AUTHOR]

The relationship among information attributes, psychological symptoms, and perceived control was examined among residents in the vicinity of Three Mile island who attended the Three Mile Island Health and Environmental Information Series on cancer, radiation, and epidemiology of cancer 6 years after the nuclear accident that had occurred and shortly before restart of the plant. Among course participants, greater understanding of information was associated with slightly fewer psychological symptoms. Higher rated reliability of information was associated with less perceived control. Findings are discussed with reference to information delivery under conditions of uncertainty. [ABSTRACT FROM AUTHOR]

High school students (N = 380) reported their attitude to nuclear power and rated various risks: nuclear and non-nuclear, personal and societal. The focus of the study concerned risks related to handling and disposal of radioactive waste, It was found that conventional personal risks obtained lower risk ratings than risks to society and risks related to accidents in the handling and disposal of radioactive waste. In general, items which made reference to radiation were rated higher than items which did not mention this aspect. Female students most often rated risk higher than did male students. Persons worried about nuclear power emphasized risks of accidents and waste disposal as problems, whereas those who did not worry trusted those in charge and saw nuclear power as quite safe, stressing its basis in advanced technological knowledge and skill. Students specializing in economics or technology were the least concerned about nuclear power risks and had the most positive attitudes to nuclear power. The results of the study are discussed in relation to risk perception discrepancies of experts and the public. We suggest that future experts will be recruited from groups that have, already in adolescence, established beliefs about nuclear technology risks that are lower than those of other groups. Compared to a national sample dominated by adults, the adolescents, especially boys, held more positive attitudes to nuclear power and rated risks of nuclear technology lower than adults. [ABSTRACT FROM AUTHOR]

Much of our knowledge concerning the short- and long-term effects of traumatic Stress and disasters has been developed through the study of victims and control subjects after the events have happened. There are a number of problems inherent in such a post hoc research strategy that make it difficult to isolate the specific contributions of the severe stressor itself to subsequent adjustment. Common problems include difficulty specifying baseline adjustment, necessary reliance on retrospective and sometimes monomethod data, difficulties in recruiting representative samples of victims, and convincing control groups. Many of these problems could be circumvented by the use of ongoing longitudinal and multimeasure studies of psychosocial development. This strategy would allow one to study the effects of severe and traumatic events as they happen to subjects during their participation in such studies. Systematic and multiple measures of baseline adjustment of victims and nonvictims as well as pre- planned assessments for postevent adjustment would be available. Problems involved in implementing such collaborative research ventures are reviewed, and solutions are proposed. [ABSTRACT FROM AUTHOR]

Links between the accident at Three Mile Island (TMI) and attitudes among residents of a distant community toward a local nuclear power plant were examined. Interviews were conducted about 18 months after TM I with 213 residents of a nuclear host community concerning the effects of TMI, expectations about local events, and attitudes toward the local plant. Residents' perceptions of the importance of TM I in relation to their attitudes were associated with the perceived hazards of the local plant and with changes in attitudes over the past five years. A path analysis showed that the perceived influence of TMI was inversely related to local acceptance of the plant through expectations of local outcomes. Perceived hazards were more strongly related to the perceived influence of TMI than to expected economic benefits. Findings suggested a strong link between a distant event and local expectations and attitudes. [ABSTRACT FROM AUTHOR]

This study examined a hypothesized relationship between the level of emotional arousal and subsequent helping behavior in a real-life bushfire emergency. Respondents were contacted after a major bushfire occurred near the city of Melbourne. They were asked a bout their emotional reactions on first hearing of the bushfire destruction and about their subsequent helping behavior. Respondents who reported feelings shock, terror, horror, or sickness donated significantly more to bush fire appeals than did respondents not reporting these emotions. Helping was also related to initial feelings of sympathy for the victims and initial feelings of wanting to help the victims. The results support a general model of emergency intervention linking emotional arousal to helping behavior. [ABSTRACT FROM AUTHOR]

Fincham (1984) has argued that Nogami and Streufert (1983) advanced a thesis which (1) attempts to empirically demonstrate that attributions for an accident are lower with severe as opposed to less severe outcomes and (2) applies these data to account for previous contradictory findings of the 'defensive attribution' literature. The present authors show that Fincham's attribution of intent to Nogami and Streufert is in error and that the divergent views of Nogami and Streufert versus those of Fincham and associates reflect legitimate but different approaches toward the problem of attribution theory and research. [ABSTRACT FROM AUTHOR]

Statistical analysis is described of data on 1000 British drivers' accident histories and their performance on a vision screening instrument. Significant positive associations are evident between various accident variables and tests of hyperphoria, right eye visual acuity, left eye acuity and binocular acuity. The clustering of associations is strongest for older drivers. The significance of hyperphoria has received little attention previously. The age-related associations with accidents parallel the decline with age of other visual abilities. Statutory re-testing of drivers' vision at about the age of 50 is recommended. [ABSTRACT FROM AUTHOR]

This article discusses the method of fault detection of linear dynamical systems by an optimally reduced order GLR method. Fault diagnosis of systems is important from the viewpoints of improving system availability and protecting against disasters, and hence many fault detection and diagnosis methods have been developed. One approach whoe effectivenss is reported is that which aodelo the unknown time-varying anomaly function adding to the system by a step function. From the fact that the anomaly function often has a significant bias over a round interval, the step-hypothesized GLR method which models the anoraly function by a step function often is used and the effectiveness is reported as well as its easiness in implementation.

The article reports on optimization of an observation system for a failure diagnosis. Anomaly diagnosis of control systems has become important from the viewpoints of improvement of availability and protection from disasters. Information about the anomaly is usually gathered through an observation system which is instrumented for a control purpose and treated appropriately. This article discusses optimization of the observation system which enables fast and accurate detection of the anomaly for the dynamical system represented by a state variable. It assumes that the treated system is a discrete linear one and that the anomaly is modeled by an unknown jump adding to the state at an unknown time.

Childhood accidental injuries are a major public health problem, whether measured in terms of morbidity or mortality, and accident prevention is subsequently a priority issue. The Accident and Emergency Notification System to health visitors provides them with vital information and statistics with which to plan accident prevention work, both on an individual basis or in group work. This small study aimed to look at this system from the health visitor's perspective and explore the action taken. The grounded theory approach was used to uncover the processes used by the health visitors. Data were collected using unstructured interviews and by writing notes. These were transcribed on the same day as recorded. Nine categories were identified and an analysis of the processes involved when receiving the notification slip is presented. The categories included 'knowing the family', 'age and development', 'pressure of work' and 'gut feeling/extra sensory perception'. This study is a small contribution to our understanding of the processes involved in everyday health visiting practice. [ABSTRACT FROM AUTHOR]

While some morbidities associated with the excessive use of alcohol are related to the total amount of alcohol consumed-cirrhosis being an example-other pathologies, such as trauma and those of psycho-social origin, are mainly related to the frequency of acute alcoholic intoxication rather than to the total amount consumed. The balance between these two types of alcohol-associated morbidities can provide an indication of the relative frequency of intoxication, and thus of the pattern of alcohol abuse in a population. Since trauma is highly associated with acute alcoholic intoxication, the prevalence of bone fractures was determined in cirrhotics in nine countries. The prevalence of rib and vertebral fractures on routine chest x-rays showed a 17-fold variation in the different countries, from 2% and 6% in Spain and Italy to 30% and 34% in Canada and the USA, suggesting marked differences in the pattern of alcohol abuse to intoxication. Conversely, the prevalence of cirrhosis is twice as high in Spain and Italy than in Canada and the USA. A strong positive correlation between per capita consumption and cirrhosis mortality ( r= 0.86; p < 0.01) exists among the nine countries studied, while the correlation between per capita alcohol consumption and the prevalence of trauma is not statistically significant ( r= - 0.40). Supporting a strong association between trauma and alcoholic intoxication, the prevalence of trauma was found to be highly correlated: r= 0.88, p < 0.002, with the degree of concern for the psycho-social consequences of alcohol abuse in the different countries. Data indicate that trauma can be used as an objective indicator to assess the pattern of alcohol abuse in a population. [ABSTRACT FROM AUTHOR]

Hong Kong's Mass Transit Railway is demonstrably one of the world's most reliable urban transport systems. However, a disruption to the service which occurred in May 1996 provides a classic example of how a crisis situation can spontaneously emerge from an otherwise highly stable action-structure. This incident, the worst on record in terms of the number of casualties, illustrates how an ordered system, characterized by positive feed-back mechanisms, can induce debilitating disorder. Consistent with Perrow's (1984) description of a ‘normal’ accident, the incident was both unpredictable and, for a time, incomprehensible to the system operator, making an immediate and proactive response somewhat problematic. The various organizational responses which followed the incident range in type from the technological fix to the creation of additional slack and the insertion of circuit-breakers designed to disrupt destructive amplifying feed-back loops. [ABSTRACT FROM AUTHOR]

Discusses the majority of accidents and disasters that are subtle and difficult to identify through the book 'Man Made Disasters,' by Barry Turner. Stages in the development of a man-made disaster; Development of the Chaos Theory; Importance of the idea of bounded rationality.

This article demonstrates that systematic biases occur in (near-)accident reporting. This conclusion is based on a quantitative document analysis of 208 reports recently written by employees of an industrial company. The effectiveness of accident reporting, as an instrument for risk management, is hampered because employees take the relationship with their colleagues into account when reporting. The way of reporting proves to vary with the horizontal and vertical relational distance of the reporting employee to the person who is held responsible for the reported event. These findings support the Normal Accident Theory and weaken the empirical basis of the High Reliability Theory. [ABSTRACT FROM AUTHOR]

Presents a review of literature which outline the problems often encountered by U.S. emergency managers engaged in mitigation and response activities. Impact of the media and behavioral response expectations; Practical suggestions designed to enhance mitigation and disaster response.

Discusses the contributions of Scott Sagan to expounding the principles of the accident theories, the High Reliability Theory (HRT) and the Normal Accident Theory (NAT), as presented in his book "The Limits of Safety." Explanation on the support of Sagan for NAT; Suggestions regarding the role of NAT and HRT in organizational safety.

Proposes an innovative alternative approach to contingency planning for emergencies using the techniques of gaming, decision analysis, and risk analysis. Discussion on the methodological tool of hindcasting; Factors to be considered if response operation is to succeed and to be perceived as a success; Problems or issues that could prevent the attainment of critical success factor; Evaluation of critical success factors and problems.

Examines some crisis management trends in various types of emergencies in the U.S. Discussion on the cost of fire protection; Management problems with chemical plant emergencies; Visual examination of the timing of major earthquakes.

Norwegian merchant seamen have a higher mortality rate from accidents than comparable groups ashore. It is shown that this is not as much due to the traditional hazards of sea life as to the more human factors. Alcohol is involved in at least one third of the accidents, A conclusion is suggested that there ma, be a selection of accident prone persons to the seafaring occupation. [ABSTRACT FROM AUTHOR]

Reports on the approach to measuring emotional dependence and independence in grade school children responding to physical injury. Assessment of mothers' behavior in relation to dependence-independence; Use of a Walk-the-Plank Test method; Sex difference in the subject of test method.

This article reports on the authors' comments on an article by Charles O. Kroncke on insurance ratemaking. In our opinion Professor Kroncke sets the tone of his article in his opening sentence in which he states, in essence, that premiums are reasonable, adequate, and not unfairly discriminatory if they are proportional to the expected losses and expected expenses of protection. Thus, in a broad sense, proportionality premiums to expected losses and expenses is neither a sufficient nor even a necessary condition for reasonable, adequate, and equitable rates. In the second paragraph. Professor Kroncke states that the classes actually used must reflect differences in the exposure of drivers, frequency of accidents, and size of losses. Even though differences in loss expectation exist among the members of a classification, it does not necessarily follow that inequities in a legal or practical sense also exist. Such differences may exist because either the state of the art is not sufficiently developed to reveal the differences, or the costs involved in further classification refinement do not justify additional refinement. In describing the computer program utilized, the author indicates that the sample is dichotomized in a way that reduces the unexplained sum of squared deviations tha most. Nonetheless, the author has stimulated our thinking, and hopefully others, about a heretofore badly neglected area of insurance ratemaking which is the theory of classification.

The article discusses the role of accident-experience learning processes in the prevention of industrial accidents in the U.S. At the outset, the author has presented a study on the frequency rate of accidents among new employees. He likewise explained through a mathematical model, the industrial learning curve phenomena. A comparison between the decrease in accident incidence and the increase in productivity has also been discussed. In his conclusion, he encouraged the participation of workers in accident prevention programs.

The article discusses the study which determines the reliability and validity of a measure based from the number of accident behaviors and predicting injuries. The study conducted meetings with the first-line supervisors from a production-type jobs to collect performance specimens for unsafe and safe behavior. The study used dispensary records to identify the number of injuries sustained by an employee during the eight-month period. Results show that the majority of specimens are classified under attitude toward exposure to hazards.

Presents the case of a 17-year old boy who is seriously injured due to a motorcycle accident and was admitted to a hospital. Complaints of the boy upon arrival to the hospital; Physical injuries observed on the boy; Conduction of tracheotomy on the boy; Effect of the operation on the health of the patient.

Rationale Nasal fractures are a common occurrence in accident and emergency and dealt with by inexperienced senior house officers. This can lead to inappropriate X-rays being performed, no proper documentation of septal haematomas and often no follow-up with a specialist team leading to in some cases complex cosmetic surgery whereas simple manipulation may have sufficed. Method We report an ambispective audit carried out on nasal fracture management in a busy district general hospital over a 6-month period. Results 46 patients were seen 24 in the first 3 months and 22 the next three. 10 had nasal X-ray performed initially on audit. Nine had no documentation of septal haematoma and seven had no follow-up arranged. After appropriate education and the setting up of a department protocol based on best practice, the next cycle was repeated. Two nasal X-rays were performed looking for foreign bodies, all patients had appropriate documentation of septal haematoma and appropriate follow-up. Conclusion Appropriate education and implementation of departmental guidelines can result in more effective and efficient use of resources when dealing with nasal fractures in accident and emergency. [ABSTRACT FROM AUTHOR]

The article examines the issues related to the burden of alcohol-related injuries, screening, brief intervention and referral to treatment (SBIRT), and research and policy recommendations in the emergency department (ED). Specific topics discussed include the usefulness of observational assessment of alcohol intoxication in the ED in lieu of blood alcohol measurement, and legal issues in identifying patients who have been drinking and practitioner attitudes and barriers to SBIRT.

The article presents abstracts about fall related injuries. They include "Reducing Fall Related Injuries in Public Hospitals," by Jennifer Cook and David Fonda, "State Falls Policy: Development to Evaluation," by Sherie Sampson, Peter Goldswain, Sue Kent and Annette Mather and "Avoiding the Tumble: Optimising Falls Prevention Uptake in the Hospital Setting Utilising Falls Resource Nurses," by Willeke Walsh, Michelle Vu and Keith Hill.

Presents abstracts of studies on trauma. 'Gastrointestinal Tract Injuries in Blunt Abdominal Trauma, A Review of the CT Findings,' by G. Creamer, I. Civil and H. Moore; 'Pelvic Fractures and Associated Injuries in Children,' by J.P. Chia, A.J.A. Holland and D.T. Cass; 'An Evaluation of a New Direct Information Transfer System; Prehospital to Resus Room,' by M. Sugrue, C. Bleakley, C. Brennan, G. Hanson, M. Salter and S. D'Amour.

Objective The objective of this study was to present a detailed examination of unintentional injuries in infants <12 months of age treated in emergency departments. Methods We conducted a retrospective analysis of data for infants <12 months of age from the National Electronic Surveillance System – All Injury Program for 2001–2004. Sample weights provided by the National Electronic Surveillance System – All Injury Program were used to make national estimates. Results An estimated 1 314 000 injured infants were treated in US emergency departments for non-fatal unintentional injuries during the 4-year period of 2001–2004, ∼1 infant every 1.5 minutes. Falls were the leading cause of non-fatal unintentional injuries for infants. Overall, the patients were more likely to be male (55.2%) than female (44.8%). Contusions/abrasions were the leading diagnosis overall (26.7%). Contusion/abrasion, laceration, hematoma, foreign body and puncture injuries occurred most frequently to the head or neck region. More than one-third of fractures (37.2%) were to the arm or hand. Bed was the product most frequently noted as being involved in the injury event for every age except 2 and 12 months (car seat was the most frequently noted product at 2 months of age, and stairs were top ranked at 12 months). Product rank changed markedly as age increased. Conclusions The influences of the social environment, the physical environment and products change as infants mature in the first year of life; this was substantiated in our study by the shift in the relative importance of products involved in injuries according to month of age. The concept that aspects of safety must adapt in anticipation of developmental stage is critical. [ABSTRACT FROM AUTHOR]

Examines a locomotive accident due to subsidence on October 22, 1892 in Lindal-in-Furness in Great Britain. Subsidence due to iron-ore mines beneath the railroad track; Movement of the ore train; Disappearance of the train due to subsidence; Response of the train company to the subsidence.

Of 77,686 case records of attendance at an accident and emergency department during 1986, 488 (0.6%) contained documented evidence of intravenous drug misuse (IDM). Clinical examination had revealed signs of soft tissue sepsis in 150 (31%) of these, the commonest sites being the wrist and forearm (31% of lesions), the antecubital fossa (19%), fingers and hand (14%) and thigh and groin (11%). These data highlight the anatomical areas to which medical and nursing staff should pay particular attention when examining patients with a background of IDM. Conversely, the presentation of soft tissue sepsis in these sites should alert clinicians to the possibility of underlying IDM. [ABSTRACT FROM AUTHOR]

Provides a clinical perspective on minor accidents and major psychological trauma. View that accidents may often appear to be minor and leading to minimal bodily injury and yet leave the patient psychologically disabled because of the patient's subjective experience of the accident.

The article presents the abstract of "Safety at What Price?" by Walter Y. Oi. The study explores that through choices in the market which reveals the implicit personal process for safety, overall exposure to risks can be controlled which may tend to lead for externalties and imperfect information. Policies to regulate safety adopt a static welfare model in which it ignores the fact that risk-taking involves a choice over time.

Objective To determine the risk of disability from unintentional injury in teenagers and young adults. Design Population-based cohort study Participants and setting Data from the National Child Development Survey (NCDS), a follow-up of 98% of children born in England, Wales and Scotland in one week in March 1958. In 1981,12 537 (76% of the original cohort) were asked about unintentional injuries since age 16 requiring hospital treatment and their consequences. Main outcome measures Incidence and type of injury based on self-reports. Incidence and nature of consequent disability also based on self-report. Results Sixty-two per cent of men and 26% of women reported at least one accident requiring hospital treatment. Thirteen per cent of these accidents resulted hospital admission and 3.2% in permanent disability. Injuries requiring admission resulted in the highest risk of disability, 9.7%. However, 54% of permanent disability reported by men and 74% reported by women followed injuries treated as outpatients. Road traffic accidents caused 42% of admissions and 31% of disability. Reports of injury requiring hospital treatment, particularly reports of more than one injury, were more common in men than women. In men the most common types of accidents happened at work (33%), during sport (26%) and on the roads (19%) while in women the most common were accidents in the home (25%), road accidents (22%) and accidents at work (20%). Conclusions Non-life threatening injuries make a significant contribution to the prevalence of permanent injury-related disability in young adults. [ABSTRACT FROM AUTHOR]

A review is presented of the article "Patterns of Accidental Craniocerebral Injury Occurring in Early Childhood" by A. G. Thomas, S. V. Hegde, R. A. Dineen and T. Jaspan, which appeared in a 2013 issue of the "Archives of Disease in Childhood".

Introduction: Injuries to the extrahepatic biliary tree at laparoscopic cholecystectomy cause major morbidity and are a major source of litigation. Injuries are often diagnosed late, leading to further complications and decreasing the chance of a successful repair. Methods: A prospective study was carried out of all patients with extrahepatic biliary injuries from cholecystectomy who were referred to the surgeons of the Universities of Melbourne Hepatobiliary Group between 1997 and 1999. Results: Twenty-seven patients sustained biliary injuries to the extrahepatic biliary tree. Twenty patients (74%) had unrecognized injuries at the time of cholecystectomy. The median time to referral was 9 days. Only two of 11 operative cholangiograms were interpreted as showing a biliary injury. Conclusion: Biliary injuries are still occurring at laparoscopic cholecystectomy. Guidelines about the management of a suspected biliary injury are discussed. Clinical, radiological and pathological assessment should enable prompt diagnosis and management should be instituted early, preferably with the involvement of a hepatobiliary specialist. [ABSTRACT FROM AUTHOR]