Injured People Research Articles

Abdominal Functional Electrical Stimulation to Augment Respiratory Function in Spinal Cord Injury.

Background: Functional electrical stimulation (FES) is the application of electrical pulses to a nerve to achieve a functional muscle contraction. Surface electrical stimulation of the nerves that innervate the abdominal muscles, termed abdominal FES, can cause the abdominal muscles to contract, even when paralysed after spinal cord injury. As the abdominal muscles are the major expiratory muscles, and commonly partially or completely paralysed in tetraplegia, abdominal FES offers a promising method of improving respiratory function for this patient group. Objective: The aim of the article is to provide readers with a better understanding of how abdominal FES can be used to improve the health of the spinal cord-injured population. Methods: A narrative review of the abdominal FES literature was performed. Results: Abdominal FES can achieve an immediate effective cough in patients with tetraplegia, while the repeated application over 6 weeks of abdominal FES can improve unassisted respiratory function. Ventilator duration and tracheostomy cannulation time can also be reduced with repeated abdominal FES. Conclusion: Abdominal FES is a noninvasive method to achieve functional improvements in cough and respiratory function in acute and chronically injured people with tetraplegia. Potential practical outcomes of this include reduced ventilation duration, assisted tracheostomy decannulation, and a reduction in respiratory complications. All of these outcomes can contribute to reduced morbidity and mortality, improved quality of life, and significant potential cost savings for local health care providers.

Traffic Accidents in the Republic of Kosovo for the Period 2014–2018

We are constantly informed of traffic accidents with fatal consequences, injuries and material damages, and thus people's lives are transformed into statistics, figures and graphs. We can conclude that fatalities on road traffic accidents reach a high level of serious consequences for family members, society and the state. For the normal and safe development of traffic, there must be the necessary infrastructure, and when it comes to infrastructure we do not mean only the roads, but any physical object and system that directly or indirectly provides services in the interest of the general public, implying also the legal infrastructure that was lacking especially after 1998 and which still continues to be incomplete. The number of fatal accidents is disturbing. Based on the statistics, Prishtina region leads with 31% of fatal accidents in comparison with other regions. In terms of the number of accidents with injuries, Prishtina region leads with 34.4%, while in number of accidents with material damage, leads with 48.1% compared to other regions. Road traffic fatalities are tragic cases, and based on numerous statistics and analysis worldwide, every year millions of people lose their lives and suffer injuries (figures range from 1.2 up to 1.3 million people in the world every year). Based on the statistics of the Kosovo Police, it is clear that they are doing a professional job, but during the analysis of statistics and the conversation (survey method) with persons who bear the burden of responsibility in this area, there is an immediate need for health and life insurance, because we have no analysis of how many injured people have remained paralyzed or with severe health problems. This issue remains to be analyzed in other periods, but it has been noted as a defect of our institutions that need to plan ahead and take stricter measures to prevent road traffic accidents.

Nursing Education in Nepal: Historical Perspective

DOI: http://dx.doi.org/10.3126/hprospect.v10i0.5670Health Prospect Vol.10 2011, pp.89-90

IDENTIFYING AND PRIORITIZING FACTORS EFFECTIVE ON HOSPITAL SERVICES QUALITY FROM THE PATIENT ATTENDANTS VIEW USING FUZZY AHP TECHNIQUE IN 2017

Objective: Hospitals play a very significant role in providing healthcare services and supplying the society's health. So, the method of evaluating hospitals services quality has a special importance. The aim of this study is to identify and prioritize factors effective on hospitals services quality from view of patients' attendants in Zeinab Hospital of Shiraz City. This study is applied in respect of objective and in respect of method, it is descriptive- applied and qualitative method has been used. The statistical population of this study is patient's attendants referring to Zeinab Hospital in 2017. Methods: For prioritizing indicators, fuzzy AHP questionnaire was used. For data analysis, Excel software was used. The study results indicate that among indicators effective on hospital services quality from patient attendants view, the access indicator with weight of 0.3373 and the general services indicator with weight of 0.3327 were located in the first and second priority respectively and the environmental indicator with weight of 0.1629 was identified as the least significant indicator respectively. Also, among subcategories of access component, sub-branches of access to medical team with weight of 0.4003 and access to round the clock services with the weight of 0.3304 were in the first and second rank respectively. Results: Among subcategories of general services indicator, subcategories of low cost with weight of 0.3623 and hospital responding to patients needs with weight of 0.3304 were the most effective sub-branches. Among subcategories of communicational component, personnel liability with weight of 0.5836 and sub-branch of personnel correct contact with patients with weight of 0.2773 were in the first and second priority respectively and finally relating to environmental component two indicators of services and facilities being up-to-date with weight of 0.4140 and having parking were in the first and second priority. Conclusion: Decision makers and managers of Zeinab Hospital should more notice the indicators of access and general services due to their significance and impact on hospital services as one of Zeinab Hospital operational approaches for promoting and improving services quality. Peer Review History: Received 20 April 2018; Revised 28 April; Accepted 9 May, Available online 15 May 2018 UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 8.5/10 Reviewer(s) detail: Dr. O.J Owolabi, University of Benin, Nigeria, owolabi@uniben.edu Dr. Omid Gholami, Sabzevar University of Medical Sciences, Iran, omidghphd@gmail.com Similar Articles: THE EFFECT OF TRAFFIC FACTORS AND TECHNOLOGY FACTORS ON CHRONOLOGICAL DELAY OF EMERGENCY (115) ON THE BESIDES OF INJURED PEOPLE IN BOYER AHMAD CITY IN 2017 EXAMINING THE IMPACT OF ACCESS TO HEALTHCARE INFORMATION IN PROVIDING SERVICE IN HOSPITAL LEVEL OF HORMOZGAN PROVINCE THE IMPACT OF HOSPITAL INFORMATION SYSTEM ON THE WORKING PROCESS OF IMAM JA’FAR SADIQ HOSPITAL, ALBORZ PROVINCE - 2016

Surveillance of carbon monoxide-related incidents — Implications for prevention of related illnesses and injuries, 2005–2014

BackgroundCarbon monoxide (CO) is an insidious gas responsible for approximately 21,000 emergency department visits, 2300 hospitalizations, and 500 deaths in the United States annually. We analyzed 10 combined years of data from two Agency for Toxic Substances and Disease Registry acute hazardous substance release surveillance programs to evaluate CO incident-related injuries. MethodsSeventeen states participated in these programs during 2005–2014. ResultsIn those 10years, the states identified 1795 CO incidents. Our analysis focused on 897 CO incidents having injured persons. Of the 3414 CO injured people, 61.0% were classified as general public, 27.7% were employees, 7.6% were students, and 2.2% were first responders. More than 78% of CO injured people required hospital or pre-hospital treatment and 4.3% died. The location for most injured people (39.9%) were homes or apartments, followed by educational facilities (10.0%). Educational services had a high number of people injured per incident (16.3%). The three most common sources of CO were heating, ventilation, and air conditioning systems; generators; and motor vehicles. Equipment failure was the primary contributing factor for most CO incidents. ConclusionsStates have used the data to evaluate trends in CO poisoning and develop targeted public health outreach. Surveillance data are useful for setting new policies or supporting existing policy such as making CO poisoning a reportable condition at the state level and requiring CO alarms in all schools and housing. Public health needs to remain vigilant to the sources and causes of CO to help reduce this injury and death.

Disaster and Multi Casualty Traige System in Nursing Practice

Triage is the process of quickly examining sick or injured people, the sorting of patients in emergency room according to the urgency of their need for care. Three categories of victim classified Red/Immediate means a patient whose life is in immediate danger and requires immediate treatment. Yellow/delayed means a patient whose life is not in immediate danger, Surgical or medical intervention is required within 2–4 hours. Green/Minimal Means a patient with minor injuries who will eventually require treatment, Minor fractures or lacerations are commonly seen in this group. Black/Expectant Means a patient who is either dead or has extensive injury and cannot be saved with the limited resources available.

Aspekti umanjivanja efekata napada improvizovanom eksplozivnom napravom u vozilu

The paper deals with tactical and technical contexts of attacks by vehicle-borne improvised explosive devices (VBIEDs). This type of attack is usually conducted aiming at so-called 'soft targets", i.e. people who are at a certain moment in the area of a planned attack. The objectives of these attacks can be diverse. The common denominator of attacks is usually to create damaging consequences, especially a large number of dead and injured people. This paper did not focus on the elimination of these attacks, but rather on the reduction of their consequences. Since their assumption is that a complete prevention of these attacks is impossible, the authors formulated some possible solutions, (regarding the technical parameters of the means in particular) to mitigate the consequences of attacks in different ways. Some measures and technical means to mitigate the effects on people are easier to implement while some are more complex and costly.

Seismic Risk Analysis for Critical Infrastructure: The Case Study of a Medical Center and its Supporting Systems in Yangon, Myanmar

Myanmar has a great strike-slip active fault called the “Sagaing Fault Zone” besides the Sumatra-Andaman Subduction Zone. Major cities (Yangon, Naypyitaw, Bago and Mandalay) are at risk along this fault. Recently, in 2012, Thabeikkyin earthquake with Magnitude of 6.8 caused collapse of many residential housings and ground failures near Mandalay. Therefore more attention should be paid for Yangon which has no large earthquakes since 1930 and is the largest not only in population but also in socio-economic activity. One of the most important concerns after an earthquake is to survive under any disastrous conditions. The medical care is requested not only for emergent injured people after an earthquake, but also for various types of patient and aged people from several weeks to longer periods. So medical center must be always functional before and after earthquake. For this purpose, medical buildings should be structurally resilient and also be functional for medical services by sustainable supply of electric power, water and any other delivery service which can be carried out by urban lifeline systems. This research is to investigate the structural vulnerability of hospital buildings and facilities, to assess the performance of urban lifeline systems and to check the operational capability of medical services in which surgical capability and life safety management method should be discussed. The water supply system is adopted as a typical lifeline system in Yangon in this study. One sample medical center in Yangon is adopted to carry out this analysis. Finally, the performance of medical services after the earthquakes can be assessed in a probabilistic manner.

Outcome and complications after treatment of facial fractures at different times in polytrauma patients

Finding the correct point of time for operative treatment of facial fractures in multiply injured people remains one of the most important challenges in modern emergency medicine. Findings relating to pathophysiological mechanisms after severe trauma argue against the early operative treatment of non-life-threatening injuries. Our retrospective analysis investigated the effects on complications and outcome of different time points for operative treatment of maxillofacial fractures in multiply injured patients.Over a period of 10 years (2003–2012) we could identify 1543 patients, of whom 553 had fractures of the facial skull. 168 of the facial fracture patients were operated on their fractures, 97 at a time later than 72 h. Despite the delayed time of operation, the patients showed fewer complications (21.6% vs 25.4%). This resulted in fewer additional stays in hospital (9.3% vs 11.3%), and also in fewer plate removals (23.7% vs 33.8%). We conclude that delayed operative fracture treatment does not lead to more complications. The optimal time for operative treatment has to be determined individually as the earliest point at which no adverse effects from comorbidities are expected.

Lean psoas area does not correlate with clinical outcomes in moderately to severely injured older people.

Frailty has been associated with worse outcomes in older trauma patients. Specifically, the utility of lean cross-sectional psoas muscle area (LPA) was examined as a potentially simple objective measure of frailty. Five hundred and fifty-four patients over the age of 65 were admitted with trauma between 2011 and 2014. Two hundred and twenty-five of these had adequate computed tomography imaging available for analysis. Cross-sectional area of the psoas muscle at the inferior endplate of L4 was quantified. Multivariate regression analysis showed no significant correlation between LPA and outcomes of mortality (P = 0.82) or inpatient complications (P = 0.22). Injury Severity Score (ISS) had a strong association with both mortality (odds ratio (OR) 9.5; 95% confidence interval (CI) 2.9-30.9) and inpatient complications (OR 9.9; 95% CI 3.5-27.7). Age also had an association with mortality (OR 1.09; 95% CI 1.03-1.16) and inpatient complications (OR 1.06; 95% CI 1.01-1.12). Lean psoas area was not an independent predictor of mortality or complications in a cohort of injured older patients.

Simulated transport time and distance from nuclear power plant to nearest university hospital in Korea

Background: Nuclear accident has a possibility of many injured people and requires urgent transfer to hospital. We investigated simulated transport time and distance from nuclear power plant to nearest university hospital by motor vehicle in Korea.Methods: This study was based on scenario design. Transport time and distance was measured on internet mapping service. We decided less than one hour is optimal on estimated arrival by motor vehicle.Results: Four nuclear power plants and twenty four nuclear reactors are operating in Korea. Each estimated arrival time to nearest university hospital is 37 min, 47 min, 1 hour 32 min and 2 hours 37 min, respectively (Gori, Wolsung, Yeonggwang and Uljin). Measured distance is 25, 27, 69 and 157 kilometers, respectively.Conclusions: Gori and Wolsung nuclear power plants require other hospital in close location or more rapid transport system.

The role of social networks in supporting the travel needs of people after serious traumatic injury: A nested qualitative study

Abstract This study explores the importance of social networks and transport for people who had experienced a traumatic injury three years earlier. Many participants found travelling difficult because of pain, discomfort, fatigue and mobility impairments caused by their injuries which led them to be highly dependent on being a passenger in cars driven by others, or on public transport and taxis, to meet their travels needs. After injury, participants’ needs to travel were often high because they had to attend regular medical and physiotherapy appointments. They also needed to be able to travel to reengage with social activities. For those who used public transport or taxis, new challenges were faced in terms of the preplanning, lack of accessibility and availability of these modes. Participants that lived in rural areas with infrequent public transport keenly felt their dependence on others for transport as did those who were wheelchair dependent where car based travel was the only option. Participants described their dependence on others for travel as feeling they were a burden. For some participants their social network could not help with travel. This meant that they either did not travel or had to absorb the costs of taxis. Practical support from the Transport Accident Commission compensation scheme in terms of taxi vouchers were useful and appreciated. However, the service provided by taxis was perceived as costly and, at times, described as unreliable and unsafe. There were many hidden costs related to supporting the travel needs of injured people. Participants who could not travel and reengage with social activities felt emotionally low, isolated and vulnerable. Service providers need to consider injured people's ability to access support for travel, the availability of accessible transport and help with travel costs in order to support their physical and psychological recovery.

Safety and security of hospitals during natural disasters: Challenges of disaster managers

The purpose of this research is to explore some challenges that hospital disaster managers face in dealing with natural disaster events. In such events, it is crucial that hospitals remain safe and functional during and after the disaster; thus, hospitals at all levels need to plan for natural disasters and be aware of the requirement to remain in an operational condition both during and after any event. Evidence from around the world suggests that the malfunctioning of hospitals during a disaster have extensive impacts on both inbound and outbound patients; as such, disaster preparedness is a significant concern for hospital disaster managers. Hospital disaster management is important because of the critical services that healthcare facilities provide for injured people and existing patients. Therefore, developing a good management system for natural disaster events can help to ensure better efficiency and economy in the use of facilities and human resources within hospitals. Although appropriate disaster management can mitigate the impact of natural disasters in hospitals, there are some barriers that can prevent the effective management of these facilities in such events. For this study, secondary information was retrieved from the Internet and via academic database on sudden-onset natural disasters, and it was found that the: awareness, knowledge, disaster preparedness of hospital staff; allocation of building codes, and the relocation of buildings to higher levels, need be improved. Also, equipping health care facilities at the time of natural disaster events is important. To manage the challenges facing hospital disaster managers, a national strategy for the disaster management planning for hospitals is required.

Development of Rope Connected Life-Saving Equipment for Transferring Numerous People

BackgroundThis study is focused on a rapid and safe transfer when there are many people who need rescuing in unapproachable location. Generally, a stretcher, a basket or a mesh drawing is used to transfer injured people or survivors in the emergency rescue, however, it turned out that it takes long time to transfer a number of people with a stretcher and it is difficult to transfer injured people safely with a basket or a mesh drawing. It would expect to transfer many people who need rescuing promptly and harmlessly. MethodsIn this article, Targeted Acceptable Responses to Generated Events of Tasks (TARGETS), an event-based team performance measurement methodology was used to investigate the effects of Mission Oriented Protective Posture (MOPP) on the behavioral processes underlying team performance during simulated rescue tasks while wearing chemical protective equipment. In addition, this study determined which team processes were related to team performance outcomes. Results of six primary analyses indicated that team process performance was not degraded by MOPP 4 on any rescue task and that the team processes critical for successful task performance are task-dependent. ResultsAs a result, authors have developed a new life-saving equipment. Numerous people who need rescuing can be quickly and safely rescued and transferred to the hospital with it. From a medical point of view, it reduces the risk of secondary damage from transport and helps avoid missing the golden time for first aid caused by delay in transferring emergency patients as numerous people can be transferred safely and quickly. ConclusionThe article is due to introduce the equipment which can transfer people who need rescuing promptly and effectively in a situation such as when numerous people need rescuing in the mountain. In a rescue situation such as mountain rescue, rope connected life-saving equipment is dropped to the rescue site with a rope from a rescue helicopter and laying down the injured on the life-saving equipment body and equip life-saving equipment to the rope consecutively. In this way, it is expected to transfer the injured rapidly and safely.

Health outcomes and costs for injured young people hospitalised with and without chronic health conditions

BackgroundThe prevalence of chronic health conditions such as diabetes among young people is increasing. Limited information is known about the impact of these conditions on young people who have been traumatically injured. Injury is the global leading cause of death and disability in young people. The aim of this study is to compare health outcomes for injured young people with and without chronic health conditions. MethodA retrospective examination of injury in young people aged≤25years with and without a chronic health condition using linked hospitalisation and mortality records during 1 January 2010 to 30 June 2014 in New South Wales, Australia. Health outcomes, including hospital length of stay (LOS), 28-day unplanned hospital readmission, hospital treatment costs, and 30-day and 12-month mortality were examined. A 1:1 matched design was used to determine excess mean hospital LOS and cost for young people with a chronic health conditions versus no health condition. ResultsThere were 184,819 injury-related hospitalisations of young people; 13.8% had a chronic health condition. Compared to young people who did not have a chronic health condition, those with one were found to have double the mean hospital cost, higher unplanned hospital readmission, and a higher rate of mortality. Injured young people had a three times higher likelihood of having a prolonged LOS if they had a chronic health condition (Adjusted odds ratio: 3.89; 95% CI: 3.69–4.11). Renal conditions, anaemia, coagulation defects, hypertension, and mental health conditions had the highest excess LOS and anaemia, hypertension, coagulation defects and renal conditions had the highest excess mean cost for matched injured individuals with and without the health condition. ConclusionsHealth outcomes following injury are worse for young people with a chronic health condition. The increasing prevalence of young people with a chronic health condition has implications for treatment, resource use, provision of support services, and survival following traumatic injury.

Health care professionals\u2019 attitudes towards evidence-based medicine in the workers\u2019 compensation setting: a cohort study

BackgroundProblems may arise during the approval process of treatment after a compensable work injury, which include excess paperwork, delays in approving services, disputes, and allegations of over-servicing. This is perceived as undesirable for injured people, health care professionals and claims managers, and costly to the health care system, compensation system, workplaces and society. Introducing an Evidence Based Medicine (EBM) decision tool in the workers’ compensation system could provide a partial solution, by reducing uncertainty about effective treatment. The aim of this study was to investigate attitudes of health care professionals (HCP) to the potential implementation of an EBM tool in the workers’ compensation setting.MethodsThe study has a mixed methods design. The quantitative study consisted of an online questionnaire asking about self-reported knowledge, attitudes and behaviour to EBM in general. The qualitative study consisted of interviews about an EBM tool being applied in the workers’ compensation process. Participants were health care practitioners from different clinical specialties. They were recruited through the investigators’ clinical networks and the workers’ compensation government regulator’s website.ResultsParticipants completing the questionnaire (n = 231) indicated they were knowledgeable about the evidence-base in their field, but perceived some difficulties when applying EBM. General practitioners reported having the greatest obstacles to applying EBM. Participants who were interviewed (n = 15) perceived that an EBM tool in the workers’ compensation setting could potentially have some advantages, such as reducing inappropriate treatment, or over-servicing, and providing guidance for clinicians. However, participants expressed substantial concerns that the EBM tool would not adequately reflect the impact of psychosocial factors on recovery. They also highlighted a lack of timeliness in decision making and proper assessment, particularly in pain management.ConclusionsOverall, HCP are supportive of EBM, but have strong concerns about implementation of EBM based decision making in the workers’ compensation setting. The participants felt that an EBM tool should not be applied rigidly and should take into account clinical judgement and patient variability and preferences. In general, the treatment approval process in the workers’ compensation insurance system is a sensitive area, in which the interaction between HCP and claims managers can be improved.

The mental health response to the Boston bombing: A three-year review

ABSTRACTThe Boston Marathon bombings left many injured people, responders, and others with short and long-term mental health needs. Very little has been published in professional journals on the mental health response to bombings and terrorism, especially in the years after the incident. Based on three years of interviews with providers, an extensive review of Boston Globe and other print media and plays and documentaries, the needs and subsequent experiences of these survivors, and the formal care and many informal supports that contributed for many to healing are described. While most people recovered quickly, others continue to struggle with longer term Post-Traumatic Stress Disorder (PTSD), hearing loss, and other invisible injuries. While professional counseling was important to many, at least of equal value were the many ways that survivors found to address these issues, the help of “perfect strangers,” and the wide variety of supports provided by individuals and organizations in the community. This often overlooked story offers important lessons for understanding what survivors of terrorism and natural disasters face, how they can be formally and informally helped, the importance of community responses, and the need to continue to organize to provide assistance to support strength and resilience in the years following such challenging events.

Factors affecting survival of patients in the acute phase of upper cervical spine injuries.

In recent years, on the one hand, the mortality rates of upper cervical spine injuries, such as odontoid fractures, were suggested to be not so high, but on the other hand reported to be significantly high. Furthermore, it has not been well documented the relationship between survival rates and various clinical features in those patients during the acute phase of injury because of few reports. This study aimed to evaluate survival rates and acute-phase clinical features of upper cervical spine injuries. We conducted a retrospective review of all patients who were transported to the advanced emergency medical center and underwent computed tomography of the cervical spine at our hospital between January 2006 and December 2015. We excluded the patients who were discovered in a state of cardiopulmonary arrest (CPA) and could not be resuscitated after transportation. Of the 215 consecutive patients with cervical spine injuries, we examined 40 patients (18.6%) diagnosed with upper cervical spine injury (males, 28; females, 12; median age, 58.5years). Age, sex, mechanism of injury, degree of paralysis, the level of cervical injury, injury severity score (ISS), and incidence of CPA at discovery were evaluated and compared among patients classified into the survival and mortality groups. The survival rate was 77.5% (31/40 patients). In addition, complete paralysis was observed in 32.5% of patients. The median of ISS was 34.0 points, and 14 patients (35.0%) presented with CPA at discovery. Age, the proportion of patients with complete paralysis, a high ISS, and incidence of CPA at discovery were significantly higher in the mortality group (p = 0.038, p = 0.038, p < 0.001, and p < 0.001, respectively). Elderly people were more likely to experience upper cervical spine injuries, and their mortality rate was significantly higher than that in injured younger people. In addition, complete paralysis, high ISS, a state of CPA at discovery, was significantly higher in the mortality group.

Sex Disparities in Elderly Trauma in Northern Iran

Introduction: Trauma is currently the ninth cause of mortality in the elderly. Several factors may have an impact on the outcomes after trauma in the elderly including background disease, sex, trauma severity, and age. The aim of this study was to understand the sex differences about trauma in this growing population. Methods: In a cross-sectional study, the records of all the traumatic injured people above 60 years of age who were admitted to a main center of trauma hospital in north of Iran in 2012 were studied. Demographic data, characteristics of road traffic incidents, and in-hospital medical profiles were derived. The analysis of data was done by using theχ 2 test and T test with SPSS Ver. 18 software. A P value of < 0.05 was considered statistically significant. Results: One thousand and eight-hundred thirty injured elderly patients were admitted during the study period. This amount accounted for 10.5% of the total injured. In this study 56.3% of victims were male with the mean age of 70.84±8.16 years in comparison to 71.65±8.59 years in women (P < 0.05). Sex differences were seen in Glasgow coma scale, place, mechanism of trauma, anatomical part injured, and in-hospital death rate (P < 0.05). Outdoor trauma was more prevalent in men and indoor trauma in women. The mechanisms causing trauma in both sexes were slipping and road traffic accidents, respectively. In men, head and neck were the most common anatomical sites injured, while most women suffered from injuries to the upper extremities. Conclusions: It seems that elderly men are more at risk of severe injury with a higher mortality rate in comparison to elderly women

A Method to Specify Requirements for A Hospital Management Software

The diagnosis of disease and the treatment, both medical and surgical, to the sick and injured people are the main role of a hospital as an institution. To achieve these objectives hospital is built in a suitable location, staffed with skilled manpower and equipped with the state of the art modem medical technologies. Nowadays, hospital as an institution is becoming an example of complex system because of the existence of increasing diverse interrelationships among its various entities/components. The management of the hospital, which is mainly manually operated, is unable to cope with this increasing diversification of the interrelationships and the information resulting form them. A computer-based information system (CBIS), which has the ability to handle large amount of information and their interrelationships in an organisation can be seen as an appropriate solution at this point. The development of an effective CBIS is not a straightforward task. This consists of a series interrelated stages such as requirement specification, system design, implementation and maintenance. Among them requirement specification is considered as the most important stage, since the viability of a CBIS mainly depends on it. Therefore, the paper presents the procedures of capturing requirement specifications for the CBIS to be used in a hospital. This can be demonstrated that the specifications in turn will enable an understanding of all aspects of the system in a consistent and coherent way and therefore to define its boundary.Keywords: CBIS, System, Requirement Specifications, Hospital and Problem Domain