OBJECTIVE: Most whiplash patients eventually recover, although some are left with ongoing pain and impairment. Why some develop long-term symptoms after whiplash, whereas others do not, is largely unknown. One explanation blames the cultural expectations of the population wherein the injury occurred, engendering the moniker whiplash culture. The purpose of this review was to locate and discuss studies that were used as a basis for developing the whiplash culture concept and to evaluate its plausibility.
METHODS: The PubMed database was searched using combinations of the terms whiplash culture, whiplash OR WAD, and chronic OR late OR long term. Search dates spanned from 1950 to June 2008. Filters were set to only retrieve English-language citations. Articles that dealt with the whiplash culture were selected and examined to determine which studies had been used to create the concept.
RESULTS: Nineteen articles discussed the cultural aspects of whiplash and were explored to determine which were used as a basis for the whiplash culture. Eight studies were found that met this final criterion.
CONCLUSION: There are many unanswered questions about the basis of chronic whiplash, and the notion of a whiplash culture is controversial. Chronic whiplash symptoms are surely not caused entirely by cultural issues, yet they are probably not entirely physical. Presumably, a tissue injury component exists in most chronic whiplash-associated disorder victims that becomes aggravated in those who are susceptible to biopsychosocial factors. As with many other controversial health care topics, the answer to the debate probably lies somewhere in the middle.
Penyakit lemah jantung merupakan antara lima punca utama kematian penyakit kronik tidak berjangkit berdasarkan rujukan World Health Organization. Sekitar 20% pesakit kegagalan jantung di seluruh dunia memasuki wad semula dalam jangka masa 30 hari selepas discaj. Hal ini demikian biasanya akibat daripada tidak mematuhi penyekatan sukatan air diminum atau pun perkembangan penyakit. Kajian ini bertujuan untuk mengenalpasti kadar masuk wad dalam 30 hari selepas discaj daripada kegagalan jantung dan faktor berkaitan di Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) pada tahun 2016-2017 dengan menggunakan data casemix. Berdasarkan data kod, perbelanjaan digunakan untuk masuk wad semula dalam 30 hari diambilkira. Kadar masuk wad untuk kegagalan jantung dalam 30 hari selepas discaj bagi punca yang sama adalah 53.5% dan 43.5% bagi tahun 2016 dan 2017, sama kadar dengan hospital mengajar yang lain tetapi lebih tinggi daripada kadar di negara maju. Selepas diselaraskan, hanya faktor umur pesakit dan tahap keterukan penyakit menunjukkan kaitan yang bermakna dengan kemasukan wad dalam 30 hari selepas discaj bagi kegagalan jantung. Jangka masa berada dalam wad dan perbelanjaan untuk kemasukkan wad adalah lebih rendah daripada yang sepatutnya dicapai. Sebanyak RM80,329.73 telah dijimatkan pada tahun 2017 atas rawatan yang pantas dan rancangan penjagaan yang komprehensif diberi kepada 19.3% pesakit gagal jantung tahap keterukan tiga. Penurunan kadar kemasukan wad semula dalam 30 hari selepas discaj juga menjimatkan kos pesakit dan menunjukkan penjagaan klinikal yang mantap dan strategi rawatan yang rapi. Kajian casemix ini boleh digunakan sebagai rujukan untuk penentuan bajet bagi unit kardiologi di PPUKM.
This paper gives a detailed account of 30 cases of childhood deaths caused by physical abuse, detected by the Suspected Child Abuse and Neglect (SCAN) team, General Hospital, Kuala Lumpur. They consisted of 12 Malays, 6 Chinese, 9 Indian, and 1 Indonesian child. Three cases could not be ascertained as to their ethnic origin. There were 13 male and 17 female children. The average age of the abused children was 2 years 5 months. The most frequent causes of death were intracranial hemorrhage and intraabdominal trauma. Of the 17 cases of intracranial hemorrhage, only four had X-ray evidence of skull fracture. This suggests the possibility of whiplash injuries with/without the abuser suspecting that he/she had injured the child. Of the 22 abusers who could be identified, there was no sex differentiation. Fathers formed the largest group of perpetrators, followed by mothers and childminders. Fifteen of the natural parents of the abused children were married, four were divorced and four were never married. Five of the abusers had aggressive personalities and three were drug addicts. Only one abuser was found to be an alcoholic even though a few were also under suspicion. For most cases, trigger factors could not be identified.