Trauma demography and clinical epidemiology of motorcycle crash–related head injury in a neurosurgery practice in an African developing country

Objective: Though motor vehicle crashes (MVCs) were the main cause of head trauma from road traffic injuries (RTIs), motorcycle crashes (MCCs) are now a major cause of RTI-related head injury (HI) in many developing countries.

Methods: Using a prospective database of HIs from a neurosurgical practice in a sub-Saharan African developing country, a cross-sectional survey was conducted for the trauma demography and clinical epidemiology of this MCC-related HI.

Results: Motorcycle crashes accounted for 57% (473/833) of all RTI-related HIs in this registry. The victims, with a mean age of 33.1 years (SD = 18.3), consisted mainly of males (83.1%), those of low socioeconomic status (>90%), and those aged between 20 and 40 years old (56%). MCCs involved only riders in 114 cases (114/473, 32.1%), of which 69% were motorcycle–motorcycle crashes. The HI was moderate–severe in 50.8%; clinical symptomatology of significant HI included loss of consciousness (92%), anisocoria (35%), Abbreviated Injury Scale head (AIS–head) score > 3 (28%), and CT-Rotterdam score > 3 (30%). Extracranial systemic injury involved the limbs most frequently, with an Injury Severity Score (ISS) >25 in 49%. The fatality rate was 24%.

MCC-related HI among pedestrian victims involved more vulnerable age groups (the young and elderly) but have lower mean ISS compared to motorcycle passengers (mean ISS = 23.5 [11.6] vs. 27.4 [13.0]; 95% confidence interval [CI], 1.27–6.49; P = .004). In addition, compared to a contemporary cohort of MVC-related HIs in our registry, MCC victims were older (mean age 34.8 years [18.0] vs. 30.8 [18.4]; P = .002); had higher proportions of certain extracranial trauma like long bone fractures (71 vs. 29%; P = .02); and suffered fewer surgical brain lesions (25.5 vs. 17.2%; P = .004).

Conclusions: Motorcycle crashes are now a significant threat to the heads, limbs, and lives of vulnerable road users in developing countries.     

A MODELING APPROACH FOR OPTIMUM SEDIMENT DETENTION POND DESIGN1

ABSTRACT: A design procedure to determine optimum size for a sediment detention pond is presented. The procedure is based on simulating the sediment removal efficiency of the pond in conjunction with temporal variations in rainfall and potential land use and/or management options. The simulation procedure is based on a combined probabilistic-deterministic modeling approach. The probabilistic model generates daily rainfall with hourly increments for a selected site. The deterministic model simulates sediment yield and concentration for drainage area (pond inflow) and sediment trapping efficiency of the pond. The sediment yield and concentration in pond effluent is estimated from the difference between sediment inflow to the pond and sediment trapped by the pond. As an example, the procedure is applied to determine optimum design for a sediment detention pond in a surface mined area using several pond design options and alternative mining operation/land reclamation strategies.     

Evaluating the sustainability potential of a white goods refurbishment program

A sustainable national policy on waste electronic and electrical equipment reuse has to ensure an integrated environmental economic and social approach. In this paper, a quantitative model is developed that permits a comparative analysis of re-use and non-re-use scenarios from an environmental and economic perspective. The model demonstrates the importance of considering user consumption profiles and the changing national electricity generation portfolio in determining the best end-of-life strategy, whether it should be reuse or recycling. A case study of Ireland is used to demonstrate the model. From a social perspective, qualitative aspects of reuse, such as the job creation potential and the impact on prosperity for low income families, are also considered. Reuse of white goods, if conducted through social enterprises, will create more employment than an equivalent amount of recycling for those most vulnerable to unemployment. Any environmental and social dividends from re-use can be realized only in the context of an economically sustainable system. This would include such factors as a secure supply of suitable equipment, a competitive cost base and sufficient revenues from sales and other sources in order for the business to survive. In an attempt to examine whether a white goods re-use program could possibly operate in a competitive manner with new appliances, this study has examined examples of comparable businesses operating in the EU as well as interpreting data on consumer demand.     

Determination of dibenzo-p-dioxin (DBD) and dibenzofuran (DBF) in paper pulp mill defoamer additives and in paper pulp samples

An analytical procedure has been developed for quantitatively measuring dibenzo-p-dioxin (DBD) and dibenzofuran (DBF) present at part-per-billion levels in paper mill defoamers and paper pulp using gas chromatography coupled with either low resolution mass spectrometry (GC-LRMS) or high resolution mass spectrometry (GC-HRMS).     

Will Limits of the Earth's Resources Control Human Numbers?

The current world population is 6 billion people. Even if we adopted a worldwide policy resulting in only 2.1 children born per couple, more than 60 years would pass before the world population stabilized at approximately 12 billion. The reason stabilization would take more than 60 years is the population momentum – the young age distribution – of the world population. Natural resources are already severely limited, and there is emerging evidence that natural forces already starting to control human population numbers through malnutrition and other severe diseases. At present, more than 3 billion people worldwide are malnourished; grain production per capita has been declining since 1983; irrigation per capita has declined 12% during the past decade; cropland per capita has declined 20% during the past decade; fish production per capita has declined 7% during the past decade; per capita fertilizer supplies essential for food production have declined 23% during the past decade; loss of food to pests has not decreased below 50% since 1990; and pollution of water, air, and land has increased, resulting in a rapid increase in the number of humans suffering from serious, pollution-related diseases. Clearly, human numbers cannot continue to increase.     

Risk assessment of landfill disposal sites--State of the art

A risk assessment process can assist in drawing a cost-effective compromise between economic and environmental costs, thereby assuring that the philosophy of 'sustainable development' is adhered to. Nowadays risk analysis is in wide use to effectively manage environmental issues. Risk assessment is also applied to other subjects including health and safety, food, finance, ecology and epidemiology. The literature review of environmental risk assessments in general and risk assessment approaches particularly regarding landfill disposal sites undertaken by the authors, reveals that an integrated risk assessment methodology for landfill gas, leachate or degraded waste does not exist. A range of knowledge gaps is discovered in the literature reviewed to date. From the perspective of landfill leachate, this paper identifies the extent to which various risk analysis aspects are absent in the existing approaches.