Week 2 - Social Ecology and Epidemiology of Trauma and Injury

Question 1

What are each of the peaks in the trimodal distribution? What does each peak represent?

Answer 1

50% of all deaths occur after the first peak of traumatic injury – within min – this death occurs on scene!!!
Other 30% - death occur typically outside of the scene within hours to min
20% - Typically occurs hours to days after injury – this occurs due to systemic injuries

Question 2

What characterizes the Intrapersonal level of analysis?

Answer 2

Characteristics of the individual, including knowledge, skills, attitudes, and behaviours.

This level focuses on personal attributes and their interaction with the environment.

Question 3

What injuries are the leading cause or ER visits for youth 10-19 yrs olds?

Answer 3

Sports related injuries are the leading cause or ER visits for youth 10-19 yrs old

Question 4

What does the organization level of the injury ice burg look at? What does it include? what does it have direct influce over? what does it have that enables them to pursue specific objectives?

Answer 4

Organizational Level:
Commercial organizations, social institutions, associations, clubs

Have structures, rules, and regulations enabling them to pursue specific objectives

Direct influence over the physical and social environments maintained within the organization

Question 5

What does the socioecological framework help explain?

Answer 5

Sustaining injury.

This framework allows for a comprehensive view of injury prevention strategies.

Question 6

Which countries shoulder the burden of suicide?

Answer 6

Low and middle income countries shoulder the burden of suicide compared to higher income countries (79% of all suicides)

Question 7

What does violence include?

Answer 7

Violence” includes assault, sexual assault, homicide, suicide, and war (collective violence)

Question 8

What is required to improve health and prevent injury?

Answer 8

Attention to the ENTIRE social system.

This highlights the interconnectedness of various societal factors in health outcomes.

Question 9

What are some risk factors for suicide? (think of 5 of them)

Answer 9

• Previous suicide attempt
• Mental illness
• Chronic pain
• Loss or loneliness
• Violence or abuse

Question 10

What does the holistic perspective/approach look at?

Answer 10

Health
Not just the product of individual biological, psychological and behavioural factors
It is the sum of collective social conditions and the core connections created when people interact with the environment in which they live, work and play
Improving health and preventing injury requires attention to the ENTIRE social system

Question 11

What does the Social Ecological Model help users understand?

Answer 11

Factors affecting behaviour.

It provides a framework for analyzing how different levels of influence impact health behaviors.

Question 12

What are the multiple levels of influence emphasized by the Social Ecological Model?

Answer 12

• Individual
• Interpersonal
• Community
• Organizational
• Society

These levels help in understanding the complexity of health behaviors.

Question 13

What does the community level of the injury ice burg look at? what does it include? What does it deal with?

Answer 13

Community level:
Structurally – geographical or political boundaries

Deals with the physical environment that we are in!

Functionally – may share demographic, cultural, ethnic, religious, or social characteristics with its members having a sense of identity and belonging, shared values, norms, communication, and helping patterns

Question 14

What is the injury iceberg model usually used for?

Answer 14

The injury iceberg model is usually used to implement injury prevention strategies

Question 15

Why are motorcycle injuries very traumatic?

Answer 15

VERY TRAMUATIC!!!!!
They don’t have the protection of a vehicle so it is the persons body that is absorbing the energy

Question 16

Examples of unintentional injuries?

Answer 16

24% Road traffic injuries
MVC
Pedestrian
Motorcycle
14% Falls
7% Drowning
5% Fire / Burns
4% Poisoning (combined)
18% Other (sports, work, etc.) combined

Question 17

What does the Injury Iceberg represent?

Answer 17

A socio-ecological model of health promotion and injury prevention.

It visually illustrates the factors contributing to injuries.

Question 18

What does the holistic perspective of health suggest?

Answer 18

Health is the sum of collective social conditions and interactions with the environment

Question 19

What do factors below the waterline in the Injury Iceberg represent?

Answer 19

Contributing factors that are less obvious but foundational to visible injuries.

These include systemic issues that are often overlooked.

Question 20

What are common causes of sports and recreation injuries?

Answer 20

• Falls
• Sports equipment
• Other objects
• Crashing into or being hit by another player

Question 21

What does the intrapersonal level of the injury ice burg look at? what does it include?

Answer 21

Intrapersonal level:
Characteristics of the individual

Includes:Knowledge, skills, life experience, attitudes, behaviours as they interface with the environment and society

Question 22

What is the goal of utilizing the Injury Iceberg Model in injury prevention?

Answer 22

To analyze WHY injuries occur.

Understanding the causes allows for better prevention strategies.

Question 23

Fill in the blank: The major causes of unintentional injuries include _______.

Answer 23

Road traffic injuries

Question 24

What does the Organizational Level encompass?

Answer 24

Commercial organizations, social institutions, and associations.

These entities have structures that influence the physical and social environments.

Question 25

Common causes of sports and recreation injuries?

Answer 25

Sports – falls, sports equipment (e.g. ball, bat, puck), other objects (e.g. a tree while snowboarding), crashing into or being hit by another player Snowboarding, skiing, etc. Hockey, soccer, football, etc. Cycling – hit by car, falling off bike, hitting something while biking ATV’s – hit by another, falling off, hitting something

Question 26

What does the tri-modal distribution relate to in trauma patients?

Answer 26

Mortality of trauma patients and its implications for nursing practice. ## Footnote Understanding this distribution is crucial for effective patient care.

Question 27

What is ejection out of a care usually associated with? why?

Answer 27

Ejection is usually associated with death due to you loosing all safety features that cars provide

Question 28

What age group has the highest overall number of bicycle-related ER visits and hospitalizations?

Answer 28

The 10-14 year age group has the highest overall number of bicycle-related ER visits and hospitalizations

Question 29

What does the interpersonal level of the injury ice burg look at? What does it include?

Answer 29

Interpersonal Level: Immediate physical environment and social networks in which an individual lives Includes family, friends, peers, colleagues, and coworkers

Question 30

What does the society level of the injury ice burg look at? What does it include? What does it impact? what is it the biggest influence on? How broad is it?

Answer 30

Larger systems often defined along political boundaries, possessing the means to distribute resources and control the lives and development of their constituent communities Includes: Economics, education, government policy, infrastructure, national psyche Biggest influence on individual behavior VERY BROAD Impacts all the other peaces of the injury iceberg

Question 31

What are the components included in the definition of 'violence'?

Answer 31

* Assault * Sexual assault * Homicide * Suicide * War

Question 32

What are the 5 types of Motor Vehicle Collision Impacts?

Answer 32

Frontal Impact Down and Under – lower extremity injuries Up and Over – neck injuries Rear Impact Can lead to frontal impact Neck injuries Lateral / Side Impact (T-Boned) Sideways impact Neck, head, Chest, Pelvic injuries Vehicle Rollover Depend on restraint of passengers Restrained experience organ damage via tears/moving inside body Ejection Serious injury 300% more likely with ejection Spinal injuries

Question 33

What is the leading cause of ER visits for youth aged 10-19?

Answer 33

Sports-related injuries

Question 34

Where do most intentional deaths occur? Why?

Answer 34

Most intentional deaths are not in developed countries due to government stability, laws, More stable government = more stable supports to help support and pay for injury prevention programs

Question 35

What are the types of motor vehicle collision impacts?

Answer 35

* Frontal Impact * Rear Impact * Lateral / Side Impact * Vehicle Rollover

Question 36

What does the biomedical model suggest+overlook?

Answer 36

Suggests: Physical event Transfer of energy producing tissue damage in an individual Reductionist perspective Narrow Overlooks importance of psychological, environmental and sociocultural factors as determinants of injury

Question 37

What is analyzed at the Interpersonal Level?

Answer 37

Immediate physical environment and social networks, such as family and friends. ## Footnote This highlights the influence of close social relationships on health behaviors.

Question 38

Whar are some growth and development implications for pedestrain injuries? (Kid vs Adult)

Answer 38

Growth and Development: Physiology (smaller/shorter) Psychology (try to unintentionally kill themselves/do not understand risks) Behavioural (play) Adult turn away – children turn towards

Question 39

What is the significance of factors above the waterline in the Injury Iceberg? What are some examples?

Answer 39

They are the most obvious and easiest to see or blame, such as speeding or distraction. ## Footnote These factors are often the immediate causes of injuries.

Question 40

What are Latent Failures in the context of the Injury Iceberg? What is an example of one? (when are they dormant until?)

Answer 40

System flaws that are dormant until a triggering event occurs. ## Footnote Examples include lack of bicycle helmet laws.

Question 41

How is the Community Level defined? What does this level consider?

Answer 41

By geographical or political boundaries and shared characteristics among members. ## Footnote This level considers demographic and cultural factors that shape community identity.

Question 42

What are the top two causes of immediate death in trauma patients?

Answer 42

* Traumatic head/spinal cord injury * Hemorrhage (major vascular injuries)

Question 43

When does the golden hour occur?

Answer 43

During the first peak on the trimodal distribution

Question 44

Risk factors for suicide?

Answer 44

Risk factors for suicide: **Previous suicide attempt Mental illness or alcohol/drug abuse Chronic pain and/or illness Loss, loneliness Violence, abuse, conflicts Change in life (loss of job, financial strain, divorce/break-up) Discrimination (indigenous groups, refugees/migrants, LGBTQ+ persons, prisoners)

Question 45

Examples/type od motorcycle injuries?

Answer 45

Energy Transfer Head-On Impact Angular Impact Ejection Laying Bike Down

Question 46

What is necessary to facilitate the adoption of healthy behaviours?

Answer 46

Creating an environment conducive to change. ## Footnote This emphasizes the importance of supportive environments in promoting health.

Question 47

What are Active Failures in the context of the Injury Iceberg? What are some examples?

Answer 47

Counterproductive behavioral responses of individuals to a triggering event. ## Footnote Examples include risky behaviors like showing off to friends.

Question 48

what countries does death most commonly occur?

Answer 48

90% of deaths occur in low and middle income countries 20-40 times more violence-related injuries compared to high income

Question 49

what group/demographic has the highest rate of ATV deaths?

Answer 49

Young men aged 20 - 24 years have the highest rate of ATV deaths.

Question 50

What defines the Society Level in the Injury Iceberg model?

Answer 50

Larger systems along political boundaries that control resources and the lives of communities. ## Footnote This level indicates the broader societal context affecting health.

Question 51

What are contributing factors to falls? (there is 7)?

Answer 51

Balance/coordination Risk-taking behaviour Occupational hazards Alcohol and substances Socioeconomic factors Medical conditions Environmental factors

Question 52

Which genders account for the majorty of suicides and self harm?

Answer 52

Males account for the majority (70-80%) of suicides in all age groups older than 14 Females account for the majority (52-72%) of self-harm in all age groups

Question 53

Active failure Vs Latent failures? (Looks at social-ecological model)

Answer 53

Active Failures: (e.g., risky behaviors, showing off to friends) Above the waterline* Counterproductive behavioral responses of individuals to a triggering event Individuals are inheritors rather than instigators of the injury sequence Latent Failures: (e.g., lack of bicycle helmet laws) Below the waterline* May be environmental, organizational, or social Origins in decisions taken by designers, builders, managers, and politicians System flaws that are dormant until a triggering event occurs

Question 54

In women, what contributes to more deadly falls?

Answer 54

losing bone density

Question 55

what are the 3 possible crashes for Pedestrian and Bicycle vs. Vehicle Crashes?

Answer 55

3 possible crashes (legs hit bumper, body hits windshield, body hits ground)

Question 56

What is the significance of the injury iceberg metaphor?

Answer 56

Visual representation of socio-ecological factors affecting health

Question 57

What is the second leading cause of death for individuals aged 15-29?

Answer 57

Suicide

Question 58

what is the second leading cause of unintentional injury death?

Answer 58

Falls

Question 59

What are the 4 things that the social ecological model looks at?

Answer 59

Helps users to understand factors affecting behaviour Provides guidance for developing successful programs through social environments Emphasizes multiple levels of influence: Individual, interpersonal, community, organizational, and society Creating an environment conducive to change is important to facilitate adoption of healthy behaviours

Question 60

What is the Globally leading cause of death for 15-29 yr olds?

Answer 60

Globally it is the leading cause of death for 15 – 29 years old

Question 61

Examples of intentional injuries?

Answer 61

16% Suicide 10% Homicide 4% Poisoning (combined) 2% War 18% Other (self-harm, assault, etc.) combined

Question 62

What does the Social Ecological Model emphasize?

Answer 62

Multiple levels of influence our behavior

Question 63

Fill in the blank: The first peak of trauma patient mortality is due to _______.

Answer 63

Traumatic head/spinal cord injury

Question 64

what are the 3 dimensions of the social-ecological model?

Answer 64

The individual and their behaviour The physical environment The social environment

Question 65

What is the second leading cause of unintentional injury death worldwide?

Answer 65

Falls

Question 66

What are the three dimensions of the Injury Iceberg?

Answer 66

* The individual and their behaviour * The physical environment * The social environment ## Footnote Each dimension plays a role in understanding injury causation.