The aim of this study was to describe the aetiology and severity of head injury in an infant (age<1 year) population presenting to a Scottish Paediatric Emergency Department (PED) and to discern preventable risk factors. The records of infants who presented to the PED of the Royal Aberdeen Children's Hospital between September 2010 and December 2011 with isolated head trauma were reviewed, patient demographics were extracted and information on aetiology, including nonaccidental injury (NAI), was recorded. Of 1574 attendances, 233 suffered isolated head injury. The majority (97%) were minor; six patients suffered skull fractures, three had traumatic intracranial haemorrhage and only three were considered to have sustained an NAI. The most common mode of injury was fall from a height (37%). Infants commonly present to the PED with head injury, many of which should be easily preventable. The number of cases because of NAI in our population is smaller than previously published figures.
Background: Suicide is one of the ten leading causes of death in the world, it ranks 8th leading cause in America and 4th as years of lost life. It accounts for more than 400,000 deaths annually. Different countries have different incidence rate and suicidal patterns, which are in accordance to their cultural, religious and social values. Suicide, a major global public health problem, is an under-studied and under researched subject in Pakistan, a conservative Islamic and developing country, with severe, legal, social and religious sanctions against it. Basic epidemiological data including national suicide rates are neither known nor reported to the World Health Organization. Despite this there is strong suggestive evidence that suicide not only occurs regularly but there has been an increase in the incidence over the last few years. Objective: The purpose of this study was to evaluate all the cases that presented in Mayo hospital Lahore from the duration 1st January 2004-31st December 2004, of attempted suicide. We wanted to find out what area they belonged to, which age group had an increased incidence, what was the male to female ratio, What method of suicide was adopted and during which season was the incidence the greatest. Materials and methods: All people who attempted suicide (medico-legal cases) from 1st January 2004 to 31st December 2004 were included in the study. Detailed information was provided by forensic department in Mayo Hospital, about age, sex, date of attempt and area they belonged to. Results: showed a male dominance, also the age group of 21-30 years showed the greatest frequency. Greater number of cases belonged to the urban area, the most common mode of suicide was by poisoning and contrary to international studies the greatest number of attempts was during the summer season. Conclusion: The results in our study show that attempted suicidal rate has rapidly increased since 1995. In 2004 almost 4/day of attempted suicide (medico-legal) cases presented in the emergency department of Ma yo hospital compared to less than 0.4/day in 1995. Our study also shows male dominance in number of attempted suicide. It also showed that in our population 21-30years had the highest number of attempts. . Our study also shows a greater number of attempts during summer months where as in the western countries a greater number is shown during spring and winter.
Background/motivationThe Trainee Lead (TL) initiative was devised by the Medical Education Team to bridge the gap between trainees and management and empower trainees to become involved in improvement processes.National training surveys (GMC/Scottish training survey) have highlighted the need for an inclusive approach and collaborative culture. The aim of the TLs is to engage trainees, promoting better communication and model a positive environment for learning and quality improvement (QI).How we did itThere are nine TLs across the divisions of Medicine, Surgery, Women’s and Children and Support Services. The role of TLs is to engage with trainees within their Divisions by having regular meetings with trainees and feeding back to the medical education team within the health board. By participating in medical education and managerial meetings, TLs have developed management skills and driven quality improvement projects.The monthly Trainee Forum was set up to raise awareness of the roles and structure of the management team. Guest speakers from the management Divisions have provided trainees with an insight into how the health board functions and provided a platform to raise issues directly with the management team.Some examples of initiatives include trainee-led QI projects to enhance teaching opportunities include rota restructuring, development of hospital at night for surgery to ensure safe and adequate cover out of hours, involvement of trainees in organisation of morbidity and mortality meetings.Furthermore, a monthly Trainee Newsletter was set up to signpost trainees on upcoming forums and advertise QI sessions and workshops.OutcomesThe TL initiative is an ongoing project with regular feedback in the form of TL meetings, forums and trainees. As TL’s we have shared methodologies that have worked well to create a supportive and nurturing environment.The initiative has resulted in increased awareness of management and their vital role in the running of the National Health Service. This in turn has led to improved trainee engagement. On a fundamental level, trainees have been able to raise issues and be part of implementing change.The futureThrough collaboration between trainees, across Divisions and with management, we will continue to engage trainees, sustain change and build resilience.
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