Chest injuries of elderly postmortem human surrogates (PMHSs) under seat belt and airbag loading in frontal sled impacts: Comparison to matching THOR tests

Abstract

Objective: The goal of the study was to develop experimental chest loading conditions that would cause up to Abbreviated Injury Scale (AIS) 2 chest injuries in elderly occupants in moderate-speed frontal crashes. The new set of experimental data was also intended to be used in the benchmark of existing thoracic injury criteria in lower-speed collision conditions.

Methods: Six male elderly (age >63) postmortem human subjects (PMHS) were exposed to a 35?km/h (nominal) frontal sled impact. The test fixture consisted of a rigid seat, rigid footrest, and cable seat back. Two restraint conditions (A and B) were compared. Occupants were restrained by a force-limited (2.5?kN [A] and 2?kN [B]) seat belt and a preinflated (16?kPa [A] and 11?kPa [B]; airbag). Condition B also incorporated increased seat friction. Matching sled tests were carried out with the THOR-M dummy. Infra-red telescoping rod for the assessment of chest compression (IRTRACC) readings were used to compute chest injury risk. PMHSs were exposed to a posttest injury assessment. Tests were carried out in 2 stages, using the outcome of the first one combined with a parametric study using the THUMS model to adjust the test conditions in the second. All procedures were approved by the relevant ethics board.

Results: Restraint condition A resulted in an unexpected high number of rib fractures (fx; 10, 14, 15 fx). Under condition B, the adjustment of the relative airbag/occupant position combined with a lower airbag pressure and lower seat belt load limit resulted in a reduced pelvic excursion (85 vs. 110?mm), increased torso pitch and a substantially lower number of rib fractures (1, 0, 4 fx) as intended.

Conclusions: The predicted risk of rib fractures provided by the THOR dummy using the C_max and PC Score injury criteria were lower than the actual injuries observed in the PMHS tests (especially in restraint condition A). However, the THOR dummy was capable of discriminating between the 2 restraint scenarios. Similar results were obtained in the parametric study with the THUMS model.     

脱硫工程项目后评估体系的研究

在论述脱硫工程项目后评估概念和特点的基础上,对后评估的主要内容和方法进行了深入的研究,认为脱硫工程项目的后评估在整个电厂建设后评估工作中占有非常重要的地位,需要在实践中不断总结、完善,建立更加符合国情的后评估理论和方法体系。     

Air quality and respiratory health in Delhi

Delhi is an instructive location for studying the impact of air pollution since it is a rapidly expanding centre of government, trade commerce and industry. We have made an attempt to (1) determine the association between environmental pollution and respiratory morbidity in Delhi for the period 1998–2004, (2) assess the impact on hospital admission of the implementation of recent governmental regulations and (3) calculate the relative risk of hospitalization due to respiratory ailments caused by air pollutants. Seven hospitals from different parts of Delhi were selected. The pollution profiles of these areas were assessed and subsequently Poisson regression model was performed for the patient population. There was a remarkable decrease in monthly average concentration of sulphur dioxide (from 17.9 to 11.1 μg m⁻³) and increase in monthly average concentration of nitrogen dioxide (from 34.2 to 49.1 μg m⁻³) after the newly introduced regulations. Particulates were observed to have marginal fall in their concentration but still remained above the permissible limits. Gaseous pollutants, in spite of being at a level lower than the permissible level, showed more consistent significant association with respiratory admissions. The relative risks of hospitalization due to respiratory diseases were in the range of 1.07–2.82 in residential cum commercial areas. Comparative study of pre and post new stringent governmental regulation showed significant positive association of NO₂ with respiratory disorders in southern (RR: 1.10; CI: 1.09–1.12) and northern regions (RR: 1.33; CI: 1.27–1.39), both mixed use areas. In spite of the improvement in the air quality, the associated health effects were found to be substantial.     

Social network characteristics and resource access among formerly displaced households in Lira,Uganda

In rural African communities, the support of extended family, friends, and neighbours is essential in borrowing or leveraging land, labour, food, and money, especially at times of social and financial turmoil. Little is known, though, about the nature of the networks and the conditions under which they may generate greater support in post‐conflict communities. This study, conducted in the Lira district of northern Uganda, examined the composition, proximity, and size of the networks that households utilise to gain access to resources during and after resettlement. Network structures with more kin and co‐resident ties were found to offer greater resource access to households in post‐conflict settings. Furthermore, there was a lack of meaningful linkages outside of a person's own village, especially with regard to households whose head has no or a low level of education. These findings enhance understanding of the specific role of relationships in social support for resource access among households in post‐conflict communities.     

以跨学科模型体系支撑经济社会绿色低碳发展

正2020年9月22日,国家主席习近平在第七十五届联合国大会一般性辩论上发表重要讲话,承诺我国将提高国家自主贡献力度,采取更有力的政策和措施,二氧化碳排放力争于2030年前达到峰值,于2060年前实现碳中和。实现"双碳"目标的关键在于控制化石能源消费,而能源是经济发展的物质基础,节能降碳措施将为我国经济发展带来显著压力。今后一段时间内,我国将面临节能减排与后疫情重建的双重挑战,亟须开展相关理论与实证研究,为绿色低碳发展提供科学依据。     

Health sector recovery in early post‐conflict environments: experience from southern Sudan

Health sector recovery in post‐conflict settings presents an opportunity for reform: analysis of policy processes can provide useful lessons. 1 The case of southern Sudan is assessed through interviews, a literature review, and by drawing on the experience of former technical advisers to the Ministry of Health. In the immediate post‐conflict phase, the health system in southern Sudan was characterised by fragmentation, low coverage of health services, dismal health outcomes and limited government capacity. Health policy was extensively shaped by the interplay of context, actors and processes: the World Bank and the World Health Organization became the primary drivers of policy change. Lessons learned from the southern Sudan case include the need for: sustained investment in assessment and planning of recovery activities; building of procurement capacity early in the recovery process; support for funding instruments that can disburse resources rapidly; and streamlining the governance structures and procedures adopted by health recovery financing mechanisms and adapting them to the local context.     

Reconciling reintegration: the complexity of economic and social reintegration of ex‐combatants in Burundi

The extent to which disarmament, demobilisation and reintegration (DDR) programmes initiated by state or multilateral agencies can realise the reintegration of ex‐combatants remains debated. While some consider that DDR should have the ambition to result in long‐term reintegration, others argue that DDR should focus on short‐term goals. This paper explores experiences with the reintegration of ex‐combatants in Burundi. It shows the interconnectedness of economic and social reintegration processes, and demonstrates that the reintegration of ex‐combatants cannot be seen in isolation from the wider recovery and development context in which DDR is taking place. Moreover, the case demonstrates that reconciliation and social reintegration are deeply interconnected, to the extent that social reintegration may fail if reconciliation is not taken into account. Rather than a debate between long‐ and short‐term goals, the focus should therefore be on increasing the understanding of reintegration processes and finding ways in which programmes can contribute to those.     

The establishment of a standard operation procedure for psychiatric service after an earthquake

This study presents information on the design and creation of a standard operation procedure (SOP) for psychiatric service after an earthquake. The strategies employed focused on the detection of survivors who developed persistent psychiatric illness, particularly post-traumatic stress and major depressive disorders. In addition, the study attempted to detect the risk factors for psychiatric illness. A Disaster-Related Psychological Screening Test (DRPST) was designed by five psychiatrists and two public health professionals for rapidly and simply interviewing 4,223 respondents within six months of the September 1999 Chi-Chi earthquake. A SOP was established through a systemic literature review, action research, and two years of data collection. Despite the limited time and resources inherent to a disaster situation, it is necessary to develop an SOP for psychiatric service after an earthquake in order to assist the high number of survivors suffering from subsequent psychiatric impairment.     

Post-conflict health reconstruction: search for a policy

Despite increasing experience in health reconstruction in societies emerging from conflict, the policy basis for investing in the development of equitable and effective health systems in the wake of war remains unsettled. Consideration of post-conflict health reconstruction is almost entirely absent in donor policies on global health. Practically by default, health programmes are seen increasingly as an element of stabilisation and security interventions in the aftermath of armed conflict. That perspective, however, lacks an evidence base and can skew health programmes towards short-term security and stabilisation goals that have a marginal impact and violate the principles of equity, non-discrimination, and quality, which are central to sound health systems and public acceptance of them. A better approach is to ground policy in legitimacy, viewing health both as a core social institution and one that, if developed according to human rights principles, including equity, non-discrimination, participation and accountability, can advance the effectiveness and the quality of governance in the emerging state.     

Understanding recovery of small enterprises from natural disaster

This study, carried out among 251 small-scale firm owners by means of a cross-sectional survey, attempted to identify the factors affecting business recovery from disaster in a flood-prone area of Bangladesh. We selected the participants by using a convenience sampling technique, taking into consideration the characteristics of the firms, and the various enabling- and disaster-impact factors needed to identify those factors significant to business recovery from natural disaster. Results demonstrated that more than three-quarters (87.3%) of owners recovered their firms after disaster. Multivariate logistic regression analyses revealed that a total of six variables had a significant impact on business recovery: two variables pertaining to the firms’ characteristics, namely, retail firms (OR?=?0.147, P?<?0.05) and the number of employees >4 (OR?=?0.094, P?<?0.01); two variables pertaining to enabling factors, namely, receiving loans (OR?=?0.232, P?<?0.01) and the perception of recovery (OR?=?16.178, P?<?0.01); and two variables pertaining to disaster-impact factors, namely, an income loss amounting to >BDT 2000 (OR?=?7.395, P?<?0.05) and permanent or temporary relocation of the market (OR?=?9.252, P?<?0.001). Results further demonstrated that almost equally half of the owners recovered their firms immediately or within 7 days after disaster (50.9%); the remaining 49.1% took longer. Multivariate analyses, on the other hand, significantly identified three characteristics, namely, 6–10 years of business operation (OR?=?0.267, P?<?0.01), 2–4 employees (OR?=?0.1.822, P?<?0.01), and a monthly income of BDT 5001–7500 (OR?=?4.167, P?<?0.01); two enabling factors, namely, institutional education (OR?=?0.400, P?<?0.05) and awareness of disaster assistance (OR?=?0.607, P?<?0.05); and two disaster-impact factors, namely, loss of human resources (OR?=?6.293, P?<?0.05) and interrupted supply of raw materials (OR?=?4.741, P?<?0.05). We concluded the study with discussions of a few policy implications.