Background: In June 2021, the Injury Research Engagement Project (I-REP) was established. In 2022, we preformed focus group analysis with patients/caregiver and researchers that resulted in themes in preferences, motivations, and best practices to increase participation in trauma research. The importance of trust and well-established relationships was common across all groups.
View Article and Find Full Text PDFObjective: To advance surgical education priorities by using electronic health record (EHR) reporting and data visualization on an Acute Care Surgery (ACS).
Design: Operational data from the EHR for the ACS service was displayed on an ACS dashboard using Tableau software. This data included new ACS consults (reason for consult, consult note author - attending surgeon and resident) and operations generated by those consults (type of operation, primary attending surgeon, and assisting resident).
Background: Despite research linking chemical and physical restraints to negative outcomes including unplanned intubations and psychological distress, there is little guidance for their use in the care of trauma patients. We used institutional data to describe recent trends in chemical and physical restraint in the emergency department evaluation and treatment of trauma patients and to identify characteristics associated with their use.
Methods: This study includes adult trauma activations at a United States urban level I trauma center from January 2016 to July 2022.
Trauma Surg Acute Care Open
February 2024
Introduction: Engaging trauma survivors/caregivers results in research findings that are more relevant to patients' needs and priorities. Although their perspectives increase research significance, there is a lack of understanding about how best to incorporate their insights. We aimed to capture stakeholder perspectives to ensure research is meaningful, respectful, and relevant to the injured patient and their caregivers.
View Article and Find Full Text PDFBackground: Routine in-person follow-up for injured patients after hospital discharge is unfeasible in low- and middle-income countries where trauma morbidity and mortality are the highest. Mobile technology screening may facilitate early detection of complications and timely treatment. In this prospective, multisite implementation study, we cross-validate the performance of a cellphone screening tool developed to risk stratify trauma patients in need of further care after discharge in Cameroon.
View Article and Find Full Text PDFThis article defines evidence-based practice (EBP) and quality improvement (QI) and examines the positive impact on patient care when they are in place, as well as the barriers to their implementation. An effective tool, Ovid Synthesis, was created to enable clinicians and administrators to streamline the processes for EBP and QI, provide oversight on the initiatives underway, and enable clinical educators to help nursing staff develop the necessary competencies and successfully execute their EBP and/or QI projects.
View Article and Find Full Text PDFBackground: The mismatch between the global burden of surgical disease and global health funding for surgical illness exacerbates disparities in surgical care access worldwide. Amidst competing priorities, governments need to rationally allocate scarce resources to address local needs. To build an investment case for surgery, economic data on surgical care delivery is needed.
View Article and Find Full Text PDFBackground: Deaths related to pregnancy and childbirth are extremely high in low-resource countries such as Uganda. Maternal mortality in low- and middle-income countries is related to delays in seeking, reaching, and receiving adequate health care. This study aimed to investigate the in-hospital delays to surgical care for women in labor arriving to Soroti Regional Referral Hospital (SRRH).
View Article and Find Full Text PDFJ Am Acad Orthop Surg Glob Res Rev
February 2023
Introduction: Extremity injuries are a leading cause of morbidity in low- and middle-income countries (LMICs), often resulting in marked short-term and long-term disabilities. Most of the existing knowledge on these injuries originates from hospital-based studies; however, poor access to health care in LMICs limits these data because of inherent selection bias. This subanalysis of a larger population-level cross-sectional study in the Southwest Region of Cameroon aims to determine patterns of limb injury, treatment-seeking behaviors, and predictors of disability.
View Article and Find Full Text PDFIntroduction: Growing research indicates transportation injury surveillance using police collision reporting alone underrepresents injury to vulnerable groups, including pedestrians, cyclists, and people of color. This reflects differing reporting patterns and non-clinicians' challenge in accurately evaluating injury severity. To our knowledge, San Francisco is the first U.
View Article and Find Full Text PDFFirearm violence is a leading cause of morbidity and mortality among young adults. Identification of intervention targets is crucial to developing and implementing effective prevention efforts. Hospital Violence Intervention Programs (HVIPs) have used a multiprong social care approach to mediate the cycle of interpersonal violence.
View Article and Find Full Text PDFBackground: Injury deaths in sub-Saharan Africa are among the world's highest, but hospital data rarely have sufficient granularity to direct quality improvement. We analyzed clinical care patterns among trauma patients who died in a prospective, multicenter sub-Saharan cohort to pinpoint trauma quality improvement intervention targets.
Methods: In-hospital trauma deaths in four Cameroonian hospitals between 2017 and 2019 were included.
Background: Home injuries are an important cause of morbidity and mortality in high-income countries. In Sub-Saharan Africa, including Cameroon, many people live in unplanned settlements with poorly constructed houses, predisposing them to home injuries. However, little is known about the epidemiology and care-seeking behaviors of the domestically injured.
View Article and Find Full Text PDFBackground: In the National Academies of Sciences, Engineering, and Medicine 2016 report on trauma care, the establishment of a National Trauma Research Action Plan to strengthen and guide future trauma research was recommended. To address this recommendation, the Department of Defense funded the Coalition for National Trauma Research to generate a comprehensive research agenda spanning the continuum of trauma and burn care. We describe the gap analysis and high-priority research questions generated from the National Trauma Research Action Plan panel on long-term outcomes.
View Article and Find Full Text PDFIntroduction: Chronic diseases are increasing but underdiagnosed in low-income and middle-income countries (LMICs), where injury mortality is already disproportionately high. We estimated prevalence of known chronic disease comorbidities and their association with outcomes among injured patients in Cameroon.
Materials And Methods: Injured patients aged ≥15 y presenting to four Cameroonian hospitals between October 2017 and January 2020 were included.
Background: Building capacity for surgical care in low-and-middle-income countries is essential for the improvement of global health and economic growth. This study assesses in-hospital delays of surgical services at Soroti Regional Referral Hospital (SRRH), a tertiary healthcare facility in Soroti, Uganda.
Methods: A prospective general surgical database at SRRH was analyzed.
Introduction: Risk factors for interpersonal violence-related injury (IPVRI) in low-income and middle-income countries (LMICs) remain poorly defined. We describe associations between IPVRI and select social determinants of health (SDH) in Cameroon.
Methods: We conducted a cross-sectional analysis of prospective trauma registry data collected from injured patients 15 years old between October 2017 and January 2020 at four Cameroonian hospitals.
Afr J Thorac Crit Care Med
October 2021
Background: Morbidity and mortality linked to injury has become an increasingly important public health concern worldwide, especially in developing countries. Despite the potentially severe nature of torso injury, little is known about the population-based epidemiology of torso injury in sub-Saharan Africa.
Objectives: To determine the incidence, identify common mechanisms, and assess the socioeconomic consequences of torso injury in Cameroon.
Background: On average, a person living in San Francisco can expect to live 83 years. This number conceals significant variation by sex, race, and place of residence. We examined deaths and area-based social factors by San Francisco neighborhood, hypothesizing that socially disadvantaged neighborhoods shoulder a disproportionate mortality burden across generations, especially deaths attributable to violence and chronic disease.
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