Objective: Despite advances in vehicle safety systems, motor vehicle crashes continue to cause ankle fractures. This study attempts to provide insight into the mechanisms of injury and to identify the at-risk population groups.
Methods: A study was made of ankle fractures patients treated at an urban level 1 trauma center following motor vehicle crashes, with a concurrent analysis of a nationally representative crash data set. The national data set focused on ankle fractures in drivers involved in frontal crashes. Statistical analysis was applied to the national data set to identify factors associated with fracture risk.
Results: Malleolar fractures occurred most frequently in the driver's right foot due to pedal interaction. The majority of complex/open fractures occurred in the left foot due to interaction with the vehicle floor. These fractures occurred in association with a femoral fracture, but their broad injury pattern suggests a range of fracture causation mechanisms. The statistical analysis indicated that the risk of fracture increased with increasing driver body mass index (BMI) and age.
Conclusions: Efforts to reduce the risk of driver ankle injury should focus on right foot and pedal interaction. The range of injury patterns identified here suggest that efforts to minimize driver ankle fracture risk will likely need to consider injury tolerances for flexion, pronation/supination, and axial loading in order to capture the full range of injury mechanisms. In the clinical environment, physicians examining drivers after a frontal crash should consider those who are older or obese or who have severe femoral injury without concurrent head injury as highly suspicious for an ankle injury. 相似文献
The concept of sustainable development has experienced great development and change at different levels of theoretical connotation and practical implementation since 1960s and 1970s when it was first proposed. People’s understanding of the relationship between economy, society, and environment has been continuously deepened over the years. When it came to the end of 2015, it is necessary to examine the results of the United Nations Millennium Development Goals on sustainable development, and at the same time, the post-2015 framework and guidance on sustainable development at the global level were to be made, including the ideas, action plans, key areas that would guide the global sustainable development. The 2030 Agenda for Sustainable Development has developed a 5P theoretical framework of being people-centered, global environmental security, sustained economic prosperity, social justice and harmony and partnership promotion, including a political declaration, 17 overarching goals and 169 specific targets, specific ways of implementation, as well as the follow-up. It is the road map to achieve global sustainable development and meet the requirements of the millennium development goals. This paper summarizes the understanding of the concept of sustainable development from its origin, its significant development, to the proposition and development of the 2030 Agenda for Sustainable Development, and its strategic impact on China. 相似文献
The establishment of the forest eco-compensation mechanism could realize the value of the forest ecosystem services partly or thoroughly, stress the equality of the stakeholders, encourage public participation in forest ecosystem tendering, and strengthen the capacity of sustainable management. Taking the Hainan province as an example, this study focuses on the analysis of major socioeconomic and ecological impacts of forest eco-compensation in the Qiongzhong County and Lingshui County, and recommends approaches and practices for the establishment of the eco-compensation mechanism in the Hainan Province. Data were collected from a household questionnaire survey. Altogether 120 households have been interviewed, and Statistical Product and Service Solutions (SPSS) was applied for data analysis. Most of the respondents held a positive attitude toward the forest eco-compensation policy which has contributed to the improvement of environmental quality. However, forest protection has limited the opportunities for the income growth of local communities, who have never got sufficient compensation from either the central or local governments. Insufficient financial support to forest institutions and local communities involved in forest management has led to major conflicts in forest management, such as, the conflict between forest protection and local economic development, and decrease in arable land area and increase in surplus labor force. On the basis of case study results, the core issues of forest eco-compensation mechanism in Hainan province are discussed. Finally, suggestions and recommendations that cover forest eco-compensation standards, management institutions, and community capacity building and diversification of financing channels, have been made for the establishment of forest eco-compensation mechanism in Hainan. 相似文献
