No abstract
Objective: For children under 15 years, drowning accounts for higher worldwide mortality rates than any other injury source. Our aim was to determine the predictors of parents accessing learn-to-swim classes for their children and whether parents' overall motivation contributed to the explanation of behavioural intention. Using an extended version of the theory of planned behaviour (TPB), incorporating past behaviour and parents' health motivation, barriers and benefits associated with parents' intentions to enrol their child/children in learn-to-swim classes were investigated. Method: Parents (N = 114) with school children in Kindergarten up to Year 6 were recruited from Australian rural communities (mean age [M] = 38.2 years; standard deviation [SD] = 7.0). They completed questionnaires including demographic information, swimming ability, direct and belief-based measures of the TPB, past behaviour, and health motivation. Belief-based measures were derived from a pilot study following Ajzen's (1991) guidelines. This was followed by administration of the main questionnaire. Results: Hierarchical regression analyses revealed that attitudes and past behaviour, respectively, predicted 55.6% and 4.5% of variance in parental intentions. Multivariate analyses of variance highlighted a number of beliefs that could be targeted in campaigns to encourage parents to involve their children in swimming classes. Conclusions: Recommendations for campaigns targeting this issue include: (a) induce positive attitudes towards enrolling children in swimming lessons and (b) target parents of children not previously enrolled in swimming lessons to influence their future intentions, with a particular focus on attitudes and changing beliefs about behaviours relevant to swimming lessons for their children.
Military experience has consistently emphasized the unacceptably high amputation rate associated with popliteal arterial trauma. In this group of patients there were 23 arterial injuries and 26 injuries involving both an artery and a vein. The loss of only 5 limbs in this series was directly related to the policy of repair of the artery by both single segment vein grafts and by 'panel' grafts. Panel grafts are prepared by removing the long saphenous vein at ankle level, splitting it longitudinally and then dividing it transversely at the midpoint. The two segments of vein are placed side by side and sutured along each side, a no. 14 or 16 Ch. Foley catheter being used as a stent. Fasciotomy, carried out at an early stage in the postoperative course, and prompt re-exploration of repair sites when suspicion arose as to the effectiveness of limb circulation, were also major factors in establishing a successful outcome in so many patients.
The results of treatment in 34 cases of penetrating injury to the popliteal vein are presented. In 26 cases there was associated damage to the popliteal artery. Satisfactory venous repair by lateral suture was achieved in 11 of 12 limbs. Autogenous vein grafts were used to repair the damaged popliteal vein in 10 limbs. In 4 the saphenous vein was anastomosed directly to the popliteal vein; in 6 cases it was used as a wide-bored panel or compilation graft. Three popliteal veins were ligated. Major postoperative limb oedema and chronic venous insufficiency were not a problem in those cases where the veins were repaired. Fasciotomy was performed in 19 of the 34 cases of venous injury. In 12 of these cases fasciotomy, performed as part of the original operation to repair the vascular injury, led to an excellent clinical result.
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