PubMed HealthSearch

Biomedical subjects

D Stueland

Publications and source records attributed to D Stueland.

9 recordsLinked to original sources

Posterior hip dislocation in a rural emergency department.

Traumatic posterior dislocation of the hip is an infrequent but potentially severe injury. A commonly recognized cause of such injuries is motor vehicle accidents. There is increasing recognition, however, that this injury can be associated with other activities including several sports. Appropriate care requires recognition and prompt treatment to prevent long-term sequelae. A review of these experiences in a rural emergency department demonstrates additional causative agents and associated events as well as makes recommendations for care.

Acetabulum

Agricultural injuries in children in central Wisconsin.

Agriculture is widely recognized as one of the most dangerous occupations in the United States. The risk of agricultural trauma extends beyond the adult work force to include farm children. During a 2-year study of agricultural trauma conducted at the Marshfield Clinic/St. Joseph's Hospital, 246 (26.9%) of all agricultural injury victims were children (age less than 19 years). Teenagers were at greatest risk, but there were also many injuries among preschool children under the age of 6 years. Injuries occurred most often during the summer months, on weekends, and during the evening hours from 6:00 PM to 10:00 PM. There were relationships between the body part injured and the age of the child as well as between the agent associated with the injury and the age and gender of the child. Preschool farm children are particularly liable to experience head and neck trauma and injuries resulting from falls. Any successful effort to address either the prevention or treatment of agricultural trauma will need to consider that children have a unique pattern of injuries that differs from that of adults.

Adolescent

All-terrain vehicle injuries in central Wisconsin: a continuing problem.

All-terrain vehicles (ATVs) have become well recognized as associated with injuries. This recognition has resulted in attempts at education and regulation to reduce the number and severity of injuries and number of deaths. The Marshfield Clinic and St. Joseph's Hospital surveyed all-terrain vehicle accidents in the Emergency Department in 1985 and again in 1988 and followed these patients for at least 1 year after the injury. Between the two dates, extensive educational and legislative activity had taken place. The actual number of all-terrain vehicle accidents had increased. The characteristics of victims who were involved in all-terrain vehicle accidents did not change. The actual number of accidents associated with three-wheeled ATVs did not appreciably decrease but the number of accidents associated with four-wheeled ATVs did increase. To date, it is not clear that legislative and educational activities are effective in reducing the number of ATV accidents or in changing the pattern of the accidents.

Adolescent

The spectrum of emergency care of agricultural trauma in central Wisconsin.

Agriculture is among the most dangerous occupations in the United States. When injuries do occur, the emergency department (ED) is the primary source of care. Over a 2-year period, the emergency medicine section of the Marshfield Clinic/St Joseph's Hospital, cared for 913 victims of agricultural trauma. Although 11% were initially admitted and 4% were later treated, the remainder received their care solely in the ED. Unlike most occupational injuries, people of any age may be involved in agricultural injuries; 27% in this series were less than 18 years of age and 5% were 65 years or older. Just over half of all injuries were from mechanical devices, including tractor and farm machinery. The remainder were from animals, falls, or exposure. Although several different types of injuries occurred, the most common diagnoses were soft tissue injuries and fractures and the most common procedure was diagnostic radiography followed by wound and fracture care. An ED in a rural setting should be prepared to deal with agricultural trauma.

Accidents

Relationship of sociodemographic and drinking variables to differentiated subgroups of alcoholics.

The results suggest that the sociodemographic variables of age, living arrangements, number of dependents, the drinking variable, and the client's perception of the type of drinker he is are the most strongly related to the derived typology. The exact relationship of these variables, as well as the variables that were moderately related to the typology, is not apparent. There is a pattern, however, that appears to run through the categories of the classification. The evidence suggests that for alcoholics to be in their prime earning years, living with their spouses, perceiving themselves as alcoholic, possessing marketable skills, and a recent history of abstinence seems to increase the likelihood of psychological need satisfaction. The antithesis--to be alcoholic, less than 30 or older than 50 years old, living by oneself or with parents, perceiving oneself as a social or problem drinker, and possessing a recent history of drinking--seems to decrease the likelihood of psychological need satisfaction. There seems to be a relationship between drinking behavior and psychological need satisfaction. As a group, the members of Clusters Two, Three, and Four are unable to abstain for longer than a week; Clusters Two and Three both possess physiological problems of adjustment. The members of Clusters One and Five tend to be able to abstain for longer periods. Cluster One is devoid of physiological difficulties, whereas Five has borderline problems. The physiological subscale of the Human Service Scale assesses the absence of symptoms associated with poor health (Realges & Butler, 1976). It appears that aberrant drinking does not necessarily result in self-perceived physiological-health complaints. These results are at variance with the belief that ethanol ingestion by an alcoholic and the resulting pathological complications are the predominant difficulties encountered by these persons. Thus it seems to us that a distraught life situation (that is, the lack of social and demographic assets--marriage, education, and so on) contributes to self-perceived severity of psychological need deprivation and not solely aberrant drinking. Therefore, in terms of recovery from alcoholism, these results argue against a unidimensional approach toward the treatment of alcoholism; that is, an approach that focuses solely on the drinking as "the" problem. A more strategic approach would include a thorough medical, psychiatric, psychological, social and vocational evaluation of the alcoholic's life situation, which in turn would permit mobilizing the efforts of a multidisciplinary team whose goal would be to maximize the resources and enhance the life situation of the alcoholic. It is hoped that the results of this study serve to increase our understanding of those factors that influence aberrant drinking.

Adult

A canonical correlation analysis of the Alcohol-Use Inventory and the Human Service Scale.

The responses of 312 persons with alcoholism to the Alcohol-Use Inventory and Human Service Scale were subjected to canonical correlation analysis. Results indicate that the relationship between alcohol-use constructs and psychological need satisfaction can be explained by two axes: a personal security--social dimension and a personal stress--environmental dimension. Microanalysis of the variates indicated that emotional need satisfaction was differentially influenced by social and physiological variables.

Adolescent