Using community medical auxiliary trainees to improve dose understanding among illiterate hospital outpatients in rural Nepal.
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Drug Information Services↗
Biomedical subjects
Wesley Rutland-Brown
Publications and source records attributed to Wesley Rutland-Brown.
Using body diagrams and disease protocols as part of an integrated approach to the medical consultation in Nepal.
Neither medical assistants nor doctors in Nepal receive adequate training in medical consultation techniques. Patients often leave the consultation with poor understanding of their disease. Moreover, disease management counselling and preventative health counselling are rarely done. In order to address these issues, simple body diagrams and disease protocols were developed and tested in a random cohort survey of 300 outpatients. While 72% of patients who were shown a body diagram achieved basic understanding of their disease, only 38% of patients who were not shown a body diagram understood their disease. This improvement was significant and independent of other factors. Satisfactory disease management counselling was given in 38% of cases, and preventative health counselling in 36%. There was correlation between use of body diagrams and provision of disease management counselling and preventative health counselling. These findings emphasize the need for simple consultation tools such as body diagrams and disease management protocols in developing countries.
Adult↗
Traumatic brain injury hospitalizations among American Indians/Alaska Natives.
OBJECTIVES: To compare the incidence of nonfatal traumatic brain injury (TBI) hospitalization among American Indians/Alaska Natives (AI/AN) with that of other race groups and to assess alcohol and protective equipment (PE) use among those who sustained TBI related to a motor vehicle (MV) incident. METHODS: Data were obtained from 13 states funded by the Centers for Disease Control and Prevention to conduct TBI surveillance from 1997 to 1999. Rates by race and by cause were calculated for the 13 states combined. Blood alcohol concentration (BAC) levels and PE use were compared between AI/AN and "other" races in a subgroup of these states. RESULTS: Although not significantly different, AI/AN had the highest overall age-adjusted TBI hospitalization rate (71.5 per 100,000). Rates were significantly higher among AI/AN than among whites for ages 20 to 44 years (78.5 per 100,000 vs 54.7 per 100,000, P < .0001). MV incidents were the leading cause of TBI (40.1% of cases) among AI/AN, and AI/AN injured in MV incidents had higher BAC levels (65.7% > or = 0.08 g/dL vs 31.6% > or = 0.08 g/dL, P < .0001) and lower PE use (22.0% vs 40.4%, P < .0001) than the "other" race group. CONCLUSION: AI/AN have high rates of TBI hospitalization compared with other races. High BAC levels and low use of PE in MV incidents appear to be associated with the higher rates in this population.
Accidental Falls↗
The incidence of traumatic brain injury among children in the United States: differences by race.
OBJECTIVE: This report summarizes the epidemiology of traumatic brain injury (TBI) deaths, hospitalizations, and emergency department (ED) visits by race among children aged 0-14 years in the United States. Few other studies have reported the incidence of TBI in this population by race. METHODS: Data from 3 nationally representative sources maintained by the National Center for Health Statistics were used to report the annual numbers and rates of TBI-related deaths, hospitalizations, and ED visits during 1995-2001 by race, age, and external cause of injury. RESULTS: An estimated 475,000 TBIs occurred among children aged 0-14 each year. Rates were highest among children aged 0-4. For children aged 0-9 years, both death and hospitalization rates were significantly higher for blacks than whites for motor vehicle-traffic-related TBIs. CONCLUSION: With nearly half a million children affected each year, TBI is a serious public health problem. Variation in rates by race suggest the need to more closely examine the factors that contribute to these differences, such as the external causes of the injury and associated modifiable factors (e.g., the use of seatbelts and child safety seats).
Accidents, Traffic↗
The epidemiology and impact of traumatic brain injury: a brief overview.
Traumatic brain injury (TBI) is an important public health problem in the United States and worldwide. The estimated 5.3 million Americans living with TBI-related disability face numerous challenges in their efforts to return to a full and productive life. This article presents an overview of the epidemiology and impact of TBI.
Brain Injuries↗
Incidence of traumatic brain injury in the United States, 2003.
Traumatic brain injury (TBI) is an important public health problem in the United States. In 2003, there were an estimated 1,565,000 TBIs in the United States: 1,224,000 emergency department visits, 290,000 hospitalizations, and 51,000 deaths. Findings were similar to those from previous years in which rates of TBI were highest for young children (aged 0-4) and men, and the leading causes of TBI were falls and motor vehicle traffic.
Accidental Falls↗