The correlation between the Military Service Adaptation Test and the Biometric Index is studied herein with the aim of preventing military safety accidents. The subjects were 36 soldiers under the age of 25 years. Based on the results of the service adaptation test, the soldiers who did not adapt to the service were distinguished. First, there was a significant difference in brain stress among the brain wave indicators of the general group and the group of interest. Second, the higher the left and right brain imbalance index among the brain wave indicators, the higher was the level of empathy shown by the subjects. Third, among the pulse indicators, the subjects with high cumulative fatigue levels were found to have high levels of emotion (anxiety, depression, physicalization) and relationship isolation (indifference, sensitivity). Based on these results, the implications of this study and suggestions for future research are discussed.
Purpose: The purpose of this study was to investigate the risk factors of intracranial hemorrhage in children with skull fractures from head trauma. Methods: The retrospective study included 205 patients diagnosed with a skull fracture in a pediatric emergency room. Data were analyzed using 𝓍2-test, Fisher's exact test, t-test, and logistic regression analysis with the SPSS/WIN24.0 program. Results: Intracranial hemorrhage was diagnosed in 71 patients. There were statistically significant differences between the hemorrhagic group and non-hemorrhagic group in age group, places of accident, type of accident, location of the fracture, and symptoms. Intracranial hemorrhage by age group was higher in school-age and adolescence than in infancy. The places of accidents of hemorrhage were higher in street and school than in the home. The types of an accident of bleeding were higher in the case of knock and traffic accident than in fall. Symptoms of nausea, headache, and loss of consciousness were associated with higher intracranial hemorrhage. Multivariable logistic regression analysis showed that knock (OR= 3.29, 95% CI= 1.50-7.22), traffic accident (OR= 4.78, 95% CI= 1.31-17.43), nausea (OR= 4.18, 95% CI= 1.42-12.31), and loss of consciousness (OR= 3.29, 95% CI= 1.41-9.50) were risk factors for intracranial hemorrhage. Conclusion: In this study, the risk factors of intracranial hemorrhage were identified in pediatric patients with skull fractures caused by head trauma. It is recommended that the results of this study be used to manage and educate patients, caregivers, and medical staff after head trauma hemorrhage.
A clinical evaluation was performed with a population of 49 patients of chest trauma, who were diagnosed to undergo ventilator therapy, and had gone through ventilator therapy at the Department of Thoracic and Cardiovascular Surgery, Kyungpook University Hospital. One of most common causes of chest trauma was vehicle accidents [77.5%] with the prevalent age group being their forties. The common findings were multiple rib fractures [89.8%], hemopneumothrax [81.6%], lung contusion [61.2%] and flail chest [44.9%]. Their common combined injuries were the orthopedics and neurosugical injuries [86.7%]. Complications caused by chest trauma were pneumonia, respiratory failure, atelectasis, barotrauma and empyema. Pulmonary infections were commonly associated with mechanical ventilation in the long term group and were best prevented by using bronchial hygiene therapy.The mortality rate was 5.8% of the total patients and that was 38.8% of the patients, who needed ventilator therapy. The causes of death were pneumonia, respiratory failure, acute renal failure and hypovolemic shock. Mechanical ventilation has an important place in the treatment of patients with severe chest trauma.
Objectives: Acute exposure to high concentrations of chemicals can occur when a chemical accident takes place. As such exposure can cause ongoing environmental pollution, such as in the soil and groundwater, there is a need for a tool that can assess health effects in the long term. The purpose of this study was assessing the health risks of residents living near a chemical accident site due to long-term exposure while considering the temporal concentration changes of the toxic chemicals leaked during the accident until their extinction in the environment using a multimedia environmental dynamics model. Methods: A health risk assessment was conducted on three cases of formaldehyde chemical accidents. In this study, health risk assessment was performed using a multimedia environmental dynamics model that considers the behavior of the atmosphere, soil, and water. In addition, the extinction period of formaldehyde in the environment was regarded as extinction in the environment when the concentration in the air and soil fell below the background concentration prior to the accident. The subjects of health risk assessment were classified into four groups according to age: 0-9 years old, 10-18 years old, 19-64 years old, and over 65 years old. Carcinogenic risk assessment by respiratory exposure and non-carcinogenic risk assessment by soil intake were conducted as well. Results: In the assessment of carcinogenic risk due to respiratory exposure, the excess carcinogenic risk did not exceed 1.0×10-6 in all three chemical accidents, so there was no health effect due to the formaldehyde chemical accident. As a result of the evaluation of non-carcinogenic risk due to soil intake, none of the three chemical accidents had a risk index of 1, so there was no health effect. For all three chemical accidents, the excess cancer risk and hazard index were the highest in the age group 0-9. Next, 10-18 years old, 65 years old or older, and 19-64 years old showed the highest risk. Conclusion: This study considers environmental changes after a chemical accident occurs and until the substance disappears from the environment. It also conducts a health risk assessment by reflecting the characteristics of the long-term persistence and concentration change over time. It is thought that it is of significance as a health risk assessment study reflecting the exposure characteristics of the accident substance for an actual chemical accident.
Purpose: This study investigated the characteristics and treatment outcomes of patients who visited the emergency department due to intoxication and analyzed the impact of the coronavirus disease 2019 (COVID-19) pandemic on their visits. Methods: A retrospective study was conducted using data from the National Emergency Department Information System (NEDIS) on patients who visited the emergency department due to intoxication between January 2014 and December 2020. In total, 277,791 patients were included in the study, and their demographic and clinical data were analyzed. A model was created from 2014 to 2019 and applied to 2020 (i.e., during the COVID-19 pandemic) to conduct a time series analysis distinguishing between unexpected accidents and suicide/self-harm among patients who visited the emergency department. Results: The most common reason for visiting the emergency department was unintentional accidents (48.5%), followed by self-harm/suicide attempts (43.8%). Unexpected accident patients and self-harm/suicide patients showed statistically significant differences in terms of sex, age group, hospitalization rate, and mortality rate. The time series analysis showed a decrease in patients with unexpected accidents during the COVID-19 pandemic, but no change in patients with suicide/self-harm. Conclusion: Depending on the intentionality of the intoxication, significant differences were found in the age group, the substance of intoxication, and the mortality rate. Therefore, future analyses of patients with intoxication should be stratified according to intentionality. In addition, the time series analysis of intentional self-harm/suicide did not show a decrease in 2010 in the number of patients, whereas a decrease was found for unintentional accidents.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
제44권6호
/
pp.269-274
/
2018
Objectives: The incidence and patterns of mandibular fractures vary by country and population age. This retrospective study evaluated the etiologies and patterns of mandibular fractures in children. Materials and Methods: The clinical records of 89 children (45 males and 44 females) aged 0 to 12 years who presented with mandibular fractures from July 2012 to June 2016 were retrospectively reviewed. The sex, patient age, site of fracture, etiology of trauma, and monthly variations of the fractures were recorded. Descriptive statistics, the z-test and chi-square test were used for statistical analysis and the P-value was set at <0.05. Results: Eighty-nine children (male-to-female ratio 1.02:1) sustained 131 mandibular fractures. Within the study sample, the 6 to 9 year age group most frequently experienced fractures (47.3%). Falls and road traffic accidents (RTA) were the two most common etiological factors that accounted for 44.9% and 24.7% of cases. The condylar fracture was the most common anatomical location (38.9%) followed by the angle (20.6%), parasymphysis (18.3%), body (15.3%), and symphysis (5.3%). A single fracture (51.7%) was more common than multiple fractures (48.3%). The month-wise distribution of mandibular fractures was fairly constant. Conclusion: The condylar region was the most common anatomic site for fractures; in addition, a fall and RTA were the major etiological factors for mandibular fractures. A single fracture was observed in 51.7% of patients while multiple fracture lines accounted for 48.3% of cases.
Purpose: Trauma is one of the most common causes of death for children, and identifying severely injured children quickly in an overcrowded emergency room (ER) is difficult. Therefore, severe injury must be prevented, and the severity of injuries in children must be determined easily from their general characteristics and pre-hospital factors. Methods: Injured children younger than 15 years of age who visited the ER from June 2011 to May 2013 were enrolled. According to the revised trauma score (RTS) of the patients, the study population was divided in two groups, a severe group (RTS<7) and a mild group ($RTS{\geq}7$). The general characteristics and the pre-hospital factors were compared between the two groups. Results: Six hundred seventy-three children were enrolled, their mean age was 8.03 (${\pm}4.45$) years, and 476 (70.73%) patients were male. Of these patients, 22 patients (3.27%) were in the severe group, and 651 patients (96.73%) were in the mild group. Fewer males were in the severe group than in the mild group (50.00% vs. 71.43%, p=0.030), and children in the severe group were younger than children in the mild group (3.50 vs. 8.00 years, p=0.049). In the severe group, toddlers (54.55%, p=0.036) were the most common age group. Severe injuries occurred more often in spring (32.81%) and summer (54.56%) than in autumn (9.09%) and winter (4.55%) (p=0.026). The most common places of injury in the severe group were roads (50.00%, p=0.009), and the most common mechanisms of injury in the severe group were traffic accidents (50.00%), followed by falls (31.82%) (p=0.011). Most severely injured children were transferred by ambulance (72.73%, p=0.000). Conclusion: The results of this study may be helpful for identifying severely injured children quickly in the field and the ER. To prevent severe pediatric injuries, precautions and policies based on these results should be established.
PURPOSES : The purpose of this study is to suggest a basis for setting appropriate safety goals specifically related to the threshold zone luminance in a vehicular traffic tunnel. METHODS : In the test, drivers were divided into two groups. One group consisted of all drivers (average drivers) group with an age ratio of drivers holding domestic driver's license and driver group by age to produce threshold zone luminance in the tunnel. The threshold zone luminance produced as a result was used to analyze how it affects the safety level of each driver group and provide a basis for setting an appropriate safety criterion that can be used to determine threshold zone luminance. We used test equipment, test conditions, and ananalysis of threshold zone luminance identical to that reported by ChoandJung(2014) but the values of adaptation luminance in our analys is were expanded to range from100 to $10,000cd/m^2$. RESULTS : Adaptation luminance and threshold zone luminance are found to be related by a quadratic function. The threshold zone luminance needed by older drivers to ensure a certain safety level is significantly higher than that for drivers of other age brackets when adaptation luminance increases. 56% of older drivers are at an increased risk of an accident at the same luminance for which the safety level of average drivers is 75%. The safety level that can be achieved for older drivers increases to above 60% when threshold zone luminance level is set with the goal of attaining a safety level of more than 85% for average drivers. The safety level that can be attained for average drivers is above 90% when the threshold zone luminance is high enough to ensure over 75% in the safety level of older drivers. Results of this study are applicable to highways and others whose designed speed is 100 km/h. CONCLUSIONS : Threshold zone luminance determined on the basis of drivers having average visual ability is of limited value as a performance standard for ensuring the safety of older drivers. Hence, safety level for older drivers should be considered separately from safety levels for drivers with an average ability to avoid risk. Upward adjustment of older drivers' safety level in the process of determining appropriate threshold zone luminance in a vehicular traffic tunnel may bring both tangible and intangible benefit as a result of reducing accidents. However, there is an associated dollar cost arising from installing and operating lights. As a result, the economic impact of these trade-offs should also be considered.
Background: Nasal bone fractures are the most common type of facial bone fracture, but are under-studied in adults above 65 years of age. Therefore, we investigated the epidemiology and patterns of nasal bone fractures among older adults in comparison to different age groups. Methods: This retrospective study included 2,321 nasal bone fracture patients who underwent surgery at our hospital from January 2010 to December 2017. The patients were classified by age as preschoolers, school-age children, young and middle-aged adults, and the elderly. We performed pairwise comparisons between elderly patients and each other age group in terms of sex, cause of injury, and fracture type. Results: The 2,321 nasal bone fracture patients included 76 elderly patients (50 men [65.8%] and 26 women [34.2%]). In these patients, the two most common injury causes were falling or slipping down (n= 39; 51.3%) and road traffic accidents (n= 19; 25.0%). According to the Stranc and Robertson classification, the most common force vector was lateral, and plane 2 fractures with lateral forces predominated. Conclusion: The elderly showed similar patterns of nasal bone fractures to those observed in young and middle-aged adults, but significant differences from preschoolers (in the injury vector and plane of fracture) and from school-age children (in the sex ratio and plane of fracture). However, elderly patients presented significantly different epidemiological characteristics compared to the other three groups. Therefore, it is necessary to improve the quality of life of the elderly and prepare for the upcoming super-aged society by taking steps to reduce the incidence and severity of fractures. Possible options for doing so include strengthening individual-level safety factors and expanding the social safety net for the elderly.
A traffic fatality by young people marked average annual decrease of 4.5% since 2011. Meanwhile, a traffic fatality by senior over 65 years old marked average annual increase of 7.9% for the last five years which means that the annual increase of traffic fatality by senior will be a serious problem. This study started questioning that senior drivers over 65 years old did not retain the same causal factor of fatal traffic accidents and thus extensively analyzed a risk of it by age group quantitatively, dividing the senior driver group into the early, middle and latter stages. Depending on the aging level, the risk of traffic fatality showed a wide difference in seven different types of traffic accidents generally, and happened to increase with latter and middle parts of the senior driver more than the early part. Therefore, this study proposes four policy suggestions: 1) The senior driver need to be offered customized driving educations and the improvement of road environment is also recommended. 2) Political assistance is needed to support and guide a safety related technology installation for the new or existing car. 3) Renewal of driving license and an aptitude test(physical examination, cognitive test) for drivers over 75 years old should take in a less than 3 years and an additional road test is needed as occasion demands. 4) Like the United States and Europe, development and extension of customized treatment guidebook for medical teams who examine senior drivers is needed and establishment of education and administration system that a supervisor of driving license renewal can impose safety restriction and American anonymity reporting system is considered to institutionalize in the medium to longer term.
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