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Over the past decade, Emergency Medical Service (EMS) systems decreased backboard use as they transition from spinal immobilization (SI) protocols to spinal motion restriction (SMR) protocols. Since this change, no study has examined its effect on the neurologic outcomes of patients with spine injuries.
The object of this study is to determine if a state-wide protocol change from an SI to an SMR protocol had an effect on the incidence of disabling spinal cord injuries.
This was a retrospective review of patients in a single Level I trauma center before and after a change in spinal injury protocols. A two-step review of the record was used to classify spinal cord injuries as disabling or not disabling. A binary logistic regression was used to determine the effects of protocol, gender, age, level of injury, and mechanism of injury (MOI) on the incidence of significant disability from a spinal cord injury.
A total of 549 patients in the SI period and 623 patients in the SMR period were included in the analysis. In the logistic regression, the change from an SI protocol to an SMR protocol did not demonstrate a significant effect on the incidence of disabling spinal injuries (OR: 0.78; 95% CI, 0.44 - 1.36).
This study did not demonstrate an increase in disabling spinal cord injuries after a shift from an SI protocol to an SMR protocol. This finding, in addition to existing literature, supports the introduction of SMR protocols and the decreased use of the backboard.
A multiyear field project focused on long-distance causeways between Uci and Cansahcab in Yucatan, Mexico, supports their use for processions and pilgrimages, their role in the creation of multisite polities, and their involvement in the constitution of local authority. Yet details of the causeways’ construction suggest that people contested this authority. Work was central to these dynamics and comes in the form of labor as practice, investments in the maintenance of relations with other-than-human beings, and the ways that causeways produced embodied experiences that were ideal for their use in pilgrimages.
Despite the success of lidar in making ancient features visible in certain tropical environments, researchers often have difficulty using lidar to identify small, low, non-linear features. This study juxtaposes lidar data with data gathered from pedestrian survey along the Ucí-Cansahcab causeway, located in the Northern Maya lowlands, to assess the degree to which the invisibility of small buildings in lidar imagery affects demographic research. The juxtaposition shows that demographic research with lidar can move forward in some cases once pedestrian survey has been used as a baseline to establish correction factors for using lidar data on their own. Another current barrier to the use of lidar is cost. This paper provides examples of the kinds of questions that can be addressed by projects with smaller budgets and, therefore, smaller amounts of lidar coverage. These questions include site size comparisons and the degree to which settlement clustered around ancient features such as the Ucí-Cansahcab causeway.
During the emergence of regional hierarchy around the site of Uci in northwest Yucatan, Mexico, ordinary people affected power relations in at least two ways. First, in the Late Preclassic and Early Classic periods, Uci had the largest ceremonial center and the largest population within a 20 km radius. Uci also physically linked itself to smaller settlements, such as Kancab and Ucanha, by means of a broad stone causeway. Yet Kancab and Ucanha's quadripartite placement of causeways and central plaza suggests that its households created a sacred landscape that gave them a degree of ritual autonomy. Ordinary people impacted power relations a second way by participating in the development of the megalithic architectural style, which was used in the region's most authoritative buildings. The use of this style in domestic platforms illustrates the ability of modest households to make their own decisions and to act in ways that constituted society at large.
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