Trauma is the leading cause of death for individuals younger than 45 years old, and unintentional injury is the third leading cause of death across all age groups in the U.S. 1,2 However, millions of patients in this country survive trauma every year and often face lifelong physical, mental, and financial problems. According to the U.S. Centers for Disease Control and Prevention, in 2013, the total lifetime medical and work loss costs of injuries and violence in the U.S. was $671 billion. 3 In an effort to gain additional insight into the provision of trauma care in the U.S., this article focuses on the National Institutes of Health (NIH)-funded study titled Comparative Assessment Framework for Environments of Trauma Care (CAFE), which is currently under way. The study is designed to assess the organizational attributes of trauma centers and trauma systems and determine the possible causes of variations in trauma patient care. This article reviews the development of U.S. trauma systems, outlines the purposes and structure of CAFE, and explains how trauma centers can contribute to this important work.
In order to fulfill our mission, theological librarians need to anticipate research needs of graduate students and faculty whose work often entails asking new questions, forming new connections, and seeking new avenues of inquiry that may lie beyond our subject expertise. What low-cost sources and tools are available that allow librarians to monitor research trends in relevant disciplines and thereby prepare ourselves to support those pursuing emerging research trajectories? How do we form the connections with current and incoming graduate students and new faculty that will enable us to anticipate their research needs? Experienced public services librarians will facilitate a conversation to address these and related questions. This session is sponsored by the Public Services Interest Group (PSIG).
Pediatric cervical spine injuries are rare events. Missed injuries must be weighed against radiation exposure and excess resource utilization in a young population. A universal pediatric cervical spine clearance algorithm does not exist. The study objective is to determine if care improved after the implementation of a standardized cervical spine clearance pathway by evaluating imaging rates, length of stay, speciality consultation, and injury detection. A multidisciplinary group reviewed relevant literature to develop an algorithm for cervical spine clearance in pediatric trauma patients. We reviewed patient charts 15 months before and after implementation. Categorical comparisons were tested with Chi-square. A p value less than 0.05 was considered statistically significant. The pre- and post-implementation groups were homogenous when comparing demographics, mechanism and severity of injury. Using the cervical spine clearance pathway, patients received fewer plain cervical spine radiographs (34% vs 16%), fewer spine speciality consults (28% vs 13%), and more patients were cleared clinically (44% vs 62%) (p < 0.05). There were 2 (1.7%) documented injuries in the pre-implementation group and 3 (3%) documented injuries in the post-implementation group. There were no missed injuries. Use of a standardized pathway allows more patients’ cervical spines to be cleared clinically and better utilizes resources without compromising patient care. Level III. Care Management Study.
Most analysts agree that excessive money growth causes inflation and that a primary goal of any central bank should be to promote price stability. Since the 1970s, the Federal Reserve has focused on growth in monetary aggregates to fight inflation. Unfortunately, the recent deregulation of the financial system and innovations in financial practices have made it more difficult to assess the implications of growth in these aggregates for future rates of inflation. As a consequence, both last year and this year the Fed declined to specify a target range for M1, the narrow transaction aggregate it once emphasized in formulating policy. The Fed also widened the target ranges for M2 and M3 in 1988 to reflect the greater uncertainty in interpreting movements in these broader savings-type aggregates.
