WMJ : official publication of the State Medical Society of Wisconsin
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The purpose of this study is to investigate the relationships among motorcycle rider helmet, alcohol use and the full spectrum of health outcomes following crashes. ⋯ Motorcycle riders who are inpatients or die in a crash are less likely to be helmeted and more likely to sustain head or face injuries. Alcohol use is associated with unhelmeted riding and increased risk of poor outcomes. These findings support policy and educational efforts promoting helmet use, which seek to decrease these tragedies.
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Horseback riding is an increasingly popular activity among today's youth, providing them with the opportunity to learn responsibility and respect for animals. However, it can also be associated with severe injury, of which many physicians are unaware. In 2002, there were an estimated 13,400 emergency department visits nationwide for horse-related injuries among children younger than 15 years. ⋯ Head injury is the injury most likely to result in hospitalization or death. The effectiveness of helmets in preventing serious head injury in horse-related accidents has been very well established. Recommendations for the prevention of horse-related injury include requiring helmet use on and near a horse, use of safety stirrups to prevent drag injury, matching rider skill with the appropriate horse, and providing close adult supervision.
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To determine the knowledge level of Head Start providers, parents, and students about booster seats and to directly observe booster seat use before and after a combined educational program and booster seat giveaway. ⋯ This study indicates that a booster seat giveaway can be successful in increasing the number of children who use booster seats; however, the majority (66%) of participating children still rode inappropriately restrained after the giveaway. Steps beyond providing booster seats, such as combining this intervention with ongoing parent and community education efforts, as well as legislation and enforcement, are needed to bring booster seat use to a high level. The information from this study may be helpful in designing future programs intended to increase booster seat use, as well as emphasizing the need for booster seat legislation.
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The issue of physician professionalism has grown in importance in recent years, in part because of perceptions that our rapidly changing health care system and the incentives associated with managed care threaten professionalism. Inherent conflicts between physician professionalism and the financial and non-financial incentives used by health care organizations in quality management may be undermining the effectiveness of quality improvement initiatives. ⋯ We contend that a systems perspective may be more compatible with physician professionalism and may be a more effective method of quality improvement that could alleviate some of the resistance that accompanies the implementation of quality improvement efforts. Disease management programs and multidisciplinary patient care teams are discussed as examples of potentially useful system-level interventions.
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Although the risk of dying during childbirth or from complications afterward has been greatly reduced during the past 100 years, the current rate of approximately 1 death in 10,000 live births is still too high. The goal of the US Department of Health and Human Services is to reduce this rate by more than half by the year 2010. ⋯ The disparity in pregnancy-related mortality ratios among ethnic groups and the finding of avoidable deaths are areas that should be targeted by health care providers and public health workers. Six areas on which to focus include the following: addressing racial disparities, assuring the performance of autopsies, lifestyle changes related to obesity and smoking, and management of embolic and cardiovascular disease, as well as postpartum hemorrhage.