Thesis (Ph. D.)--University of Queensland, 2001. / Includes bibliographical references.

The aim of this study was to investigate the prevalence, etiology and types of injuries to permanent incisors among schoolchildren aged 10-14 years from Maseru, Lesotho. Upper and lower permanent incisors were examined for dental injuries.

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The aim of this study was to investigate the prevalence, etiology and types of injuries to permanent incisors among schoolchildren aged 10-14 years from Maseru, Lesotho. Upper and lower permanent incisors were examined for dental injuries.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in the branch of Surgery Johannesburg, 2012 / Trauma and intentional injury form a major burden of disease in South Africa. This study examines the patterns of injury resulting from interpersonal violence presenting at a Level One trauma centre serving an urban population. This was a cross-sectional analysis of patients attending the Johannesburg Hospital Trauma Unit, over a period of forty-one consecutive days. In keeping with the worldwide experience of trauma care, the study showed the burden of trauma rests heavily upon young males. A majority of the incidents involved a weapon, used for penetrating or blunt injury. In cases where the weapon was documented, it was more commonly a weapon carried by one of the individuals involved such as a firearm or knife, than an item obtained spontaneously during the conflict. Patients subjected to weapon-based violence were significantly more likely to require advanced or invasive radiology, admission and operation. Weapon type influenced the pattern of injury sustained and the need for specialist consultation. It did not significantly affect admission or operation rates. Although blunt assault without a weapon may cause multiple injuries, they tended to be superficial injuries either allowing for discharge from the emergency room immediately or following a period of observation. This study showed the presence of a weapon greatly increases the morbidity resulting from the event for the patient and increases the subsequent cost to the healthcare system.

Digitized by Kansas Correctional Industries

Downhill skiing is associated with recreation, youth, speed, aerials and crowded courses which carry increased risk of injuries. The aim of this study was to evaluate downhill sport injuries in a Swedish ski resort. Material and methodsIn a case-control study ongoing 1989/90–2006/07, 3,696 injured skiers were registered. After informed consent the injured were assessed by a physician and asked to answer a questionnaire concerning skier, skiing and injury. ResultsAfter three years 481 injured skiers (41% females, mean age 23) were assessed. The injury rate was 1.13/1,000 skier days. Knee injury was most common (28%), followed by head/neck (13%) and lower leg (11%). Fractures were less common (23%) than sprains (44%). Among skiers below the age of 20, fractures outnumbered sprains. Helmet usage was high among children (<10 years; 83%), but very rare in adults. The injured skiers rarely tested positive for alcohol (1.1%, uninjured 5.0%) and no effect on skiing or injury rates were registered.A one-year follow-up about the ski injury outcome shows that the mean sick leave was 40 days and that 29% still had symptoms.94 injured telemark skiers were assessed over 11 years (females 36%, mean age 28). The ankle was the most common injury location (28%), followed by knee injury (19%) and injuries of head/neck (17%). Beginners suffered most ankle injuries (37%). The use of high-shafted boots increased (24% to 67%), while injuries to the ankle/foot diminished from 35% to 22%.568 snowboard injured were studied over 10 years (females 34%, mean age 19). Snowboard riding increased strongly during the period (<5% to 26%). The injury rate was 3/1,000 skier days. Injuries were mostly located in the upper extremities (54%). Head/neck accounted for 17%. Wrist fracture was the most common diagnosis (20%). Beginners had a higher incidence of lower arm/wrist injuries while advanced riders had more head/neck injuries.1,833 injured alpine skiers were evaluated over 16 years (females 45%, mean age 24). The injury rate was the lowest of all downhill ski sports (1.1/1,000 skier days). The lower extremity was the most common injury location (51%), the knee being the most commonly injured body part. Knee injuries affected females (39%) more often than males (23%). Head/neck injury came second (12%). Lower leg injury was most frequent in children (<10 y; 32%). Sprains were more common (43%) than fractures (22%). Beginners took fewer risks, had more falls and were injured relatively often. Helmet usage increased (25% to 58%). Helmet users reduced their risk of head injury. The severity of injury (AIS 3–6) decreased (3,4% to 1,6%).The over all results (18 years) showed similar injury incidences to the separate studies but a few specific diagnoses, e.g. knee injuries showed variations. ConclusionThe injury rate was highest in snowboarding and lowest in alpine skiing. Knee injury, especially in females, was the most common injury, the upper extremity in snowboarding and the lower extremity in telemark skiing. Helmet usage increased rapidly. Helmets have a protective effect. Ski safety work should focus on risk groups. Lift owners need to take the responsibility for ski safety work.

Surgery-induced brain injury (SBI) refers to trauma caused by routine neurosurgical procedures that may result in post-operative complications and neurological deficits. Unlike accidental trauma, SBI is potentially subject to preemptive interventions at the time of surgery. SBI can cause bleeding, inflammation and the formation of tissue gaps. Conventional haemostatic techniques, though effective, are not necessarily conducive to healing. Inflammation and the absence of extracellular matrix in tissue gaps also hinder regeneration after SBI. This study investigated the applications of RADA16-I, a type I self-assembling peptide nanofibre scaffold (SAPNS), and mesenchymal stem cells (MSCs) in the treatment of SBI. Using animal SBI models, treatments were applied immediately and locally onto the operative fields, taking advantages of the haemostatic and cell-carrying properties of RADA16-I, the immune- modulatory effects of MSCs, and the earliest available therapeutic window for SBI. There were three objectives. Objective 1 was to compare RADA16-I with conventional haemostatic methods, including electrocautery and fibrin sealant, in their effects on the brain’s acute cellular inflammatory response. The hypothesis was that RADA16-I would cause the same or a lesser degree of inflammation. This study showed that RADA16-I was superior to electrocautery, and was noninferior to conventional topical haemostats. Objective 2 was to study the in vitro expansion of MSCs within RADA16-I in preparation for in vivo transplantation. The hypothesis was that the in vitro survival of MSCs would vary between different RADA16-I concentrations and culturing methods. This study showed that plating MSCs onto pre-buffered RADA16-I would protect the cells against RADA16-I’s intrinsic acidity and result in better initial survival. Subsequent integration with the RADA16-I hydrogel, however, was poor. Mixing the cells directly with RADA16-I caused initial cell loss but allowed better integration. RADA16-I at lower concentrations resulted in better survival but also more fragile hydrogels that were mechanically unfit for transplantation. Mixing MSCs with 0.5% RADA16-I for seven days represented a compromise between these competing factors. Objective 3 was to study the in vivo effects of a MSC-RADA16-I implant on tissue reactions after SBI. The hypothesis was that the combinatorial therapy would result in less cellular inflammatory response than MSC alone or RADA16-I alone. Implants of pre-buffered 0.5% RADA16-I hydrogel, with or without cells, were found to cause less inflammation than control. MSCs in free suspension resulted in significantly more pronounced inflammation than when carried in RADA16-I. Supplementing RADA16-I with MSCs, however, did not confer additional benefit over RADA16-I alone. The present study provided new preclinical evidence to support future clinical testing of RADA16-I as a novel surgical haemostat. It also demonstrated the feasibility of early intracerebral transplantation of RADA16-I hydrogel in the treatment of SBI. Whether RADA16-I and/or transplanted MSCs could modulate the brain’s inflammatory response after SBI require further investigations, which may include the search for the optimal ex vivo expansion technique and specifically tailored nanofibre scaffold. The translational applications of these findings would include the treatment of SBI over critical brain regions where trauma would cause severe functional deficits and where better healing would facilitate patient recovery. / published_or_final_version / Anatomy / Doctoral / Doctor of Philosophy

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

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