Trauma recidivism is reduced with engagement in psychosocial programming following orthopaedic trauma.

INTRODUCTION: Recidivism is common following injury. Interventions to enhance patient engagement may reduce trauma recidivism. Education, counseling, peer mentorship, and other resources are known as Trauma Recovery Services (TRS). The authors hypothesized that TRS use would reduce trauma recidivism. METHODS: Over five years at a level 1 trauma center, 954 adults treated operatively for pelvic, spine, and femoral fractures were reviewed. Recidivism was defined as return to trauma center for new injury within 30-months. All patients were offered TRS. Multivariate logistic regression statistical analysis was used to identify predictors of recidivism. RESULTS: Three hundred and ninety-seven of all patients (42 %) utilized TRS, including educational materials (n = 293), peer visits (n = 360), coaching (n = 284), posttraumatic stress disorder (PTSD) screening (n = 74), and other services. Within the entire sample, 136 patients (14 %) returned to the emergency department for an unrelated trauma event after mean 21 months. 13 % of TRS users became recidivists. Overall, 49 % of recidivists had history of pre-existing mental illness. High rates of TRS engagement between recidivists and non-recidivists were seen (75 %); however, non-recidivists were more likely to use multiple types of recovery services (49 % vs 34 %, p = 0.002), and were more likely to engage with trauma peer mentors (former trauma survivors) more than once (91 % vs 81 %, p = 0.03). After multivariable analysis, patients using multiple different recovery services had a lower risk of recidivism (p = 0.04, OR 0.42, 95 % CI [0.19-0.96]). CONCLUSIONS: Multifaceted engagement with recovery programming is associated with less recidivism following trauma. Future study of resultant reductions in healthcare costs are warranted. LEVEL OF EVIDENCE: Level II; Prognostic.

Enhancing Trauma Patient Experience Through Education and Engagement: Development of a Mobile Application.

The purpose was to determine the utility of an open access mobile device application (App: http://bit.ly/traumaapp) to improve patient education and engagement. Methods: A patient education app was developed with information regarding injury, treatment, and recovery for orthopaedic and other injuries. Data regarding usage, satisfaction, and desired improvements were gathered. Results: The app was downloaded 725 times, and the pages in the app were viewed 9,043 times in 34 months. User sessions >2 minutes accounted for 34%. Participation was less in those older than 55 years (12% versus 68% P < 0.001). Sixteen percent of patients did not have a device to use the app. Most (55%) rated it as helpful or extremely helpful; 78% of users were likely to recommend it. Patients most frequently suggested more information on other injuries and simpler language. Discussion: There was strong interest in this simple, free patient education app. Despite an urban, trauma population, five of six patients had access to a device that could load the app. Nearly half of the patients downloaded an orthopaedic patient education app when offered. Those who did not use the app were more likely to be older than 55 years. This represents an innovative opportunity for education and engagement of our patients and their families.

Room-Temperature Phosphorescent Platinum(II) Alkynyls with Microsecond Lifetimes Bearing a Strong-Field Pincer Ligand.

The use of organometallic triplet emitters in organic light emitting diodes (OLEDs) is motivated by the premise of efficient intersystem crossing leading to unit internal quantum efficiencies. However, since most devices are based on solid-state components, an inherent limitation to square-planar platinum(II) phosphors is their tendency toward aggregation-based quenching. Here, a new class of emissive, four-coordinate PtII species based on the bisimidazolyl carbazolide (BIMCA) ligand is introduced, which displays highly efficient, long-lived solid-state phosphorescence at room temperature. A set of four BIMCAPt phenyl acetylides were synthesized that emit in the green (λmax =507-540 nm) with >60 % quantum yield and millisecond lifetimes. The structures of the resulting species reveal a non-planar structure imposed by steric clashes between BIMCA and the iodo or alkynyl co-ligand. Ground-state and photophysical characterization are presented. Density functional theory calculations indicate that the BIMCA ligand dominates the frontier orbitals along with the first Franck-Condon singlet and triplet excited states.