bluuebunny/crossref_metadata_2025 huggingface dataset:
RISK OF ASSAULT AMONG EDUCATION SPECIALISTS IN THE UNITED STATES: A CASE-CONTROL STUDY
Authors: Gerberich S , Nachreiner N , Ryan A , Church T , Mongin S
Published: October 2012

Background

School violence threatens educators, in addition to students. From initial analyses, education specialists (ES, advanced academic degree training), were identified at high risk for assaults, compared with all other education professionals (OEP) (kindergarten through grade 12: OR 6.35, 95% CI 4.46 to 9.04).

Aims/Objectives/Purpose

Investigate assault risks for ES and OEP.

Methods

Randomly selected licensed Minnesota educators (n=26 000) were screened by mailed questionnaire; 6469 were eligible (worked in previous year). Phase 1 identified 372 educators reporting student-perpetrated physical assaults in the previous year. Phase 2 (case-control study) identified exposures in the month before assaults (cases) or randomly selected work months for 1116 controls. Confounders were selected for multivariable logistic regression analyses using directed acyclic graphs to examine assault risks for ES and OEP; reweighting adjusted for potential response and unknown eligibility biases.

Results/Outcome

Increased risks (OR, 95% CI) were found for ES:student contact hours(1.2, 1.009 to 1.3per hour); andinadequate school resources(‘always’/'frequently' vs ‘sometimes:’ 3.38, 1.52 to 7.51). Reduced risks were identified for ES: ≥8 vs <8 years of experience as an educator(0.51, 0.27 to 0.95);students assigned(10+ vs <10 years of age: 0.47, 0.26 to 0.84);part-time versus full-timecontract (0.25, 0.11 to 0.59); worked in schools with>1000 vs 501–1000 students(0.37, 0.19 to 0.74).

Compared to ES, OEPs had increased risks for:inadequate building safety(‘always’/'frequently' versus ‘sometimes’: (4.82, 2.18 to 10.66); assignedstudents' racial statusdifferent from educator (3.43, 1.99 to 5.91); worked inurban versus suburbanschools (2.49, 1.55 to 4.01).

Significance/Contribution to the Field

Identification of risk differences enables targeted opportunities for interventions essential to educators.
FOOTBALL EVENTS AND THEIR ASSOCIATION WITH INTERPERSONAL VIOLENCE DEATHS
Authors: Sanchez AI , Krafty RT , Weiss HB , Puyana JC , Gutierrez MI
Published: October 2012

Background

Sporting events are associated with violence, creating societal and healthcare system burdens. However, these associations have not been objectively evaluated in low- and middle-income countries.

Aim

To determine whether football events were associated with changes in homicide rates in the city of Cali, Colombia, during 2005–2008.

Methods

Football days were those in which the city's professional teams or the national team played nationally or internationally. Daily counts of homicides were obtained from the city's fatal injury surveillance system. Homicide rates were computed using population estimates to adjudicate person-years (PY) of exposure. In stepwise conditional autoregressive negative binomial regressions adjusted for victims' demographics, known socio-political and cultural factors, weekends, holidays, trends, and seasonality, homicide rates during football days were compared against homicide rates during non-football days.

Results

There were 1352 homicides during 279 football days and 4767 homicides during non-football days (Rate, 82 and 68 per 100 000 PY, respectively, p<0.001). There was an increased risk of homicides during the 182 days of home games (IRR=1.11, 95% CI 1.02 to 1.22) compared to non-football days. There was an increased risk of homicides during the day following the football games (IRR=1.09, 95% CI 1.01 to 1.17) compared to other days. The outcome of the games was not statistically associated with increased homicide rates (IRR=1.07, 95% CI 0.97 to 1.18).

Significance

In Cali, violence prevention efforts should be increased on days of home games and on the day following the football games. The healthcare system should be prepared these days for increased demands on trauma care to prevent detrimental effects on performance and patient care.
USING ACCESSIBLE COST EFFECTIVE TECHNOLOGY TO SAVE LIVES
Authors: Weir A , Sherker S
Published: October 2012

Background

1. Public safety is an important issue for coastal management and planning.

2. Despite continued efforts, coastal drowning continues at unacceptable levels.

3. SLS has many systems in place to collect, analyse and communicate information.

4. Maintaining this information is very resource intensive.

Objectives

In order to address these issues SLSA has developed a suite of low cost, high tech, location based tools. These tools are used for a range of applications including, public education, data collection, event risk management and coastal public safety risk assessment.

Methods

BeachSafe

A website and location based iPhone app containing information on all of Australia's 11 900 beaches. The application is backed by the ABSAMP Database, developed jointly by Prof. Andrew Short (University of Sydney) and SLSA.

Event Risk Management Application

Every year SLSA conducts the Australian Surf Life Saving (SLS) Championships This event has more competitors than the Commonwealth Games and is held in the most unpredictable of environments, the beach. SLSA has developed user friendly, guided, risk management tools for the iPad. This application is currently used at the Australian SLS Championships providing real time information on the ever changing risk levels to the event emergency services.

Coastal Public Safety Risk Assessment Application

SLSA provides commercial risk management services to local government and other organisations as required to mitigate coastal public safety risk. SLSA has developed a ground breaking enterprise tool for this purpose that revolutionises this service. This application allows for the rapid collection of data and instant reporting, as well as validating and updating data in contained in the ABSAMP database.

This presentation will illustrate how SLSA is addressing coastal public safety issues using these cost effective and efficient applications.
AGE PATTERN OF DROWNING MORTALITY ACROSS 44 COUNTRIES
Authors: Lu T H
Published: October 2012

Background

Drowning mortality rates varied across age groups and countries because of differential exposure of body of water and activities.

Objective

To have a global assessment of problems of drowning deaths, this study aimed to examine the age pattern of drowning mortality across countries.

Methods

We used WHO mortality database of the latest available years to calculate age-specific drowning mortality in each country. To identify the age pattern, 95% CIs of mortality rate was computed to determine if particular age group had significant higher rate. We identified five types of age pattern.

Results

Of 44 countries analysed, seven countries had high rates among children, 12 countries had high rates among elderly, seven countries had higher rates among both children and elderly, 12 countries (all in Eastern Europe) had higher rates among working age and six countries did not have significant high rates among particular age group. Within each age pattern group, huge differences in mortality level and proportions of nature of body of water involved and mechanisms of drowning were found between countries. For example, the mortality rate for children aged 0–4 years was 49.7/100 000 in China but was only 0.8/100 000 in Germany. The percentage of bathtub drowning among elderly aged 65 years or above was 72% in Japan but was only 2% in Finland. For deceased aged 45–64 years, Czech Republic, Finland, Netherland and Taiwan had higher percentage of drowning following fall into natural water than percentage of drowning while in natural water.

Significance

Diverse age pattern drowning mortality rate, drowning mortality level, nature of body of water involved and mechanism of drowning across countries suggest that different strategies should be designed for countries with different geographic environment, climate, and cultural activities.
EVIDENCE-BASED DROWNING AND INJURY PREVENTION: COASTAL PUBLIC SAFETY AT HOT WATER BEACH AND PAKIRI BEACH
Authors: Mulcahy N , Sullivan B
Published: October 2012

Background

Surf Life Saving New Zealand developed a risk assessment programme to help the water safety sector identify high risk locations and resource them accordingly. To date, assessments have been conducted at 110 beaches and recommendations implemented at two sites, Hot Water Beach and Pakiri Beach.

Aims/Objectives/Purpose

This programme aims to reduce the incidence of drowning and injury by sharing with decision-makers the most effective safety interventions for a particular site, and encouraging efficient use of limited resources.

Methods

The risk assessments involved the identification of hazards, extraction of information from stakeholders and accumulation of supporting data (eg, incident data). Data was analysed and risk mitigation plans formulated. Stakeholders were brought together to discuss the plans and assist with their implementation. Collaboration has been essential to the programme's success.

Results/Outcomes

Various safety interventions were implemented at the sites, including the installation of safety signage and emergency phones, extension of surf lifeguarding services and targeted education. Initial data indicates the evidence-based approach is having a significant impact. The sites will be monitored over the next decade.

Significance/Contribution to the Field

An evidence-based approach to drowning and injury prevention is essential to understand why people continue to drown, and to develop effective risk mitigation. Historically drowning prevention initiatives have been ‘one size fits all’; this programmes site-specific strategy is an innovative approach to drowning prevention.
DIFFERENTIATING PATTERNS OF HEALTH SERVICE USE FOLLOWING SEVERE TRAUMATIC BRAIN INJURY: AN IDIOGRAPHIC ANALYSIS
Authors: Collie A , Prang K
Published: October 2012

Background

Traumatic Brain Injury (TBI) can result in lifelong physical and behavioural impairments that necessitate long-term access to healthcare services. Provision of health services to those with severe TBI is a major cost for health and injury compensation systems. Statistical trajectory modelling allows differentiation of patterns of health service utilisation (HSU) following TBI.

Objective

To differentiate and describe patterns of HSU following severe TBI.

Method

Detailed sub-acute HSU data for 316 cases of adult severe TBI (GCS 3–8) was extracted from the injury compensation database of the Transport Accident Commission in Victoria, Australia. Data comprised of monthly observation counts of HSU over the 60-month period post injury. A semi-parametric group-based trajectory analytical technique for longitudinal data was used to identify distinct clusters of participant trajectories.

Results

Four patterns of HSU trajectory were identified. Group 1 (27% of participants) displayed a rapid decrease in HSU in the first 12 months post injury which stabilised to an average of 1–2 services per month thereafter. Group 2 (24%) had a sharp peak in HSU post-injury (25–36 services per month) and a gradual decline over time. Group 3 (32%) displayed a peak in the first months post injury (16–25 services per month), and then a very slow decline. Group 4 (17%) displayed a steady rise from 16 to 36 services per month, and then a gradual decrease in the final 2 years.

Significance

Idiographic analysis of subacute HSU using trajectory modelling allows differentiation of distinct patterns of HSU following severe TBI. Such analysis may aid health system resource planning and management.
EXPLORING PATIENT PERCEPTIONS OF BARRIERS AND FACILITATORS TO RECOVERY FOLLOWING TRAUMA
Authors: Gabbe B , Sleney J , Gosling C , Wilson K , Sutherland A , Hart M , Watterson D , Christie N
Published: October 2012

Background

The consequences of injury are many, resulting in diverse patient outcomes and recovery experiences. While disability is prevalent post-injury, ‘why’ and ‘how’ patient and system factors interact to impact on patient recovery is not known, and requires a qualitative study approach.

Aims/Objectives/Purpose

The aims were to: (i) Explore the individual and societal impacts of trauma experienced by survivors of serious injury; and (ii) Provide evidence of the facilitators and barriers to recovery for trauma survivors.

Methods

In-depth interviews of 120 hospitalised trauma patients were conducted. Participants were recruited from the Victorian Orthopaedic Trauma Outcomes Registry and the Victorian State Trauma Registry in Australia. Purposeful quota sampling was used to ensure a range of ages, and injury severity, with the intention to ensure equal representation by gender and compensation status. The interviews were recorded and transcribed to enable thematic content analysis.

Results/Outcome

Most participants reported positive experiences with acute care with most negative experiences related to lack of coordination of post-discharge care, poor communication with health care providers, pain management issues and delays in accessing services. Many experienced some emotional impact from their injury, describing the experience as ‘life changing’. Financial consequences were common, particularly for working age participants. Support of family and friends, and a resilient or positive attitude were considered the most important facilitators of recovery.

Significance/Contribution to the Field

The narratives provided an unparalleled insight into the issues faced by injured participants as they recover, and provide valuable information for informing recommendations for improving trauma care.
FACTORS ASSOCIATED WITH ONGOING TRAUMATIC BRAIN INJURY-RELATED SYMPTOMS AMONG FEMALE OFFENDERS
Authors: Pickelsimer E , Ferguson P , Cornelius M
Published: October 2012

Background

Ongoing traumatic brain injury (TBI)-related symptoms, post-traumatic stress disorder (PTSD), and substance dependency (SuD) can greatly affect an offender's ability to function while incarcerated and upon community reentry.

Aims/Objectives/Purpose

To identify factors associated with ongoing TBI-related symptoms among female offenders.

Methods

275 female offenders were asked whether they experienced any of 19 ongoing symptoms after TBI. Variables (aggression, PTSD, mental health treatment, SuD, childhood victimisation, lack of parental/caregiver support, intimate partner violence, free or reduced lunch (ie, SES proxy) were entered into a Robust Poisson model (p≤0.25) to identify factors associated with having symptoms. Race did not meet criteria for model entry.

Results/Outcomes

(1) 154 of 275 (56%) offenders reported ongoing TBI-related symptoms. (2) SuD and PTSD were associated with having symptoms. An interaction was found between SuD and PTSD (p=0.0236). (3) An association was further found between females with PTSD and TBI-related symptoms among those without SuD (adjusted prevalence ratio (APR)=2.58; CI 1.49 to 4.45, p=0.0006), but not among those with SuD (APR=1.30; CI 0.98 to 1.73, p=0.0662). (4) Compared to having neither condition, the APR for the association between SuD and TBI-related symptoms was 2.32 (CI 1.34 to 4.01). The APR for the association with TBI-related symptoms among offenders with both SuD and PTSD, compared to having neither, was 3.03 (CI 1.80 to 5.08).

Significance/Contribution to the Field

PTSD and SuD are closely associated with ongoing TBI-related symptoms. Treating and managing all three conditions concurrently, as well as prevention efforts, would likely be cost effective and benefit both the female offenders and society.
AN INTERVENTION FOR STUDENTS' BICYCLE INJURY IN MIDDLE SCHOOLS IN RURAL CHINA
Authors: Li-ping L , Yan-ru Y , Yang G , Yao-gui L , Ming-zhi Z , Griffiths S
Published: October 2012

Background

Bicycle riding is an important means of transportation by students in rural areas of China. Little intervention research is available on developing injury prevention strategies.

Aims/Objectives/Purpose

To explore effective intervention to reduce bicycle injuries in rural middle school students of China.

Methods

A one-year cluster-randomized controlled trial was conducted in the grade-one students of six middle schools in two towns in Shantou, China. The two towns were randomly assigned to either intervention or control group. Educational materials and activities were delivered to 1381 students in the intervention group during one interventional year, and the content of intervention included traffic safety knowledge, the method of preventing bicycle injury and how to handle the bicycle injury. Questionnaires were carried out on the two groups before and after the intervention to measure incidence rate and cognitive and behavioral level of bicycle injuries.

Results/Outcomes

The pre-intervention incidence of bicycle injuries had no significant difference between the two groups ( χ2 = 2.326,p=0.127 ), while the difference reached significance after intervention ( χ2 = 13.409,p < 0.001 ). In the intervention group, the incidence rate decreased significantly after intervention ( χ2 = 8.137,p = 0.004 ), while no significant change was found in the control group ( χ2 = 0.098,p = 0.755 ) . There was significant difference in the cognitive level of bicycle injuries (p < 0.01 ), with no difference in the behavioral level (p > 0.05 ) before and after intervention In the intervention group.

Significance/Contribution to the field

The intervention is effective to reduce the incidence of bicycle injuries and improve the students' cognitive level in a short term. Long term effect and the targeted prevention strategies still need further study.
DETERMINANTS OF PARENT PERCEPTIONS OF DANGEROUS TRAFFIC RELATED TO SCHOOL TRAVEL
Authors: Rothman L , Macarthur C , To T , Buliung R , Howard A
Published: October 2012

Background

Walking to/from school is an important source of physical activity for children. Parents' perceptions of dangerous traffic affect whether or not their child walks to/from school. The determinants of parent's perceptions of dangerous traffic are currently unknown.

Aims/Objectives/Purpose

To determine which objective measures of the built environment and traffic at elementary schools are related to parent's perceptions of traffic danger.

Methods

Trained observers conducted school site surveys, vehicle speed/volume measurements and counts of school transportation modes in Toronto, Canada during school drop-off time. Parent surveys were distributed to grades 4–6 classrooms in 20 schools. Parents rated traffic danger en route to school and at school during drop-off as ‘not dangerous’, or ‘dangerous’. Multivariate cluster analyses were conducted.

Results

729 parent surveys were returned with approximately ¼ of parents reporting either their child's route to school and/or school drop off time were dangerous. Higher measured car speed was a significant determinant of both dangerous route and drop-off. Parent-reported measure of distance and numbers of roads crossed were significantly related to dangerous route. Both ratings of danger were inversely related to reported walking to/from school.

Significance

Car speed was the only objectively measured built environment feature of the school site related to parent's perceptions of traffic danger. The relationship between features of the larger neighbourhood environment surrounding schools and parent perception of traffic danger requires investigation in order to further determine what influences children walking to school.
ARE ROAD TRAFFIC ACCIDENTS PREVENTABLE AMONG SLEEP APNOEA PATIENTS?
Authors: Antonopoulos C , Sergentanis T , Daskalopoulou S , Petridou E
Published: October 2012

Background

Drowsiness and lack of concentration among obstructive sleep apnoea (OSA) patients may strongly contribute to road traffic accidents (RTAs).

Aims/Objectives/Purpose

A meta-analysis was conducted in order to estimate whether RTAs can be prevented after treatment with continuous positive airway pressure (nCPAP) among (OSA) patients.

Methods

Real accidents, near miss accidents and accident-related events in the driving simulator were used as the primary outcomes after nCPAP treatment. Pooled ORs, incidence rate ratios (IRRs), standardised mean differences (SMDs), risk differences (RDs) and numbers needed to treat (NNTs) were appropriately calculated.

Results/Outcome

Concerning real accidents (10 studies, 1221 patients), a statistically significant reduction in RTAs was recorded (OR=0.21, 95% CI 0.12 to 0.35, random effects model; IRR=0.45, 95% CI 0.34 to 0.59, fixed effects model). A stronger reduction on near miss accidents (5 studies, 769 patients; OR=0.09, 95% CI 0.04 to 0.21, random effects model; IRR=0.23, 95% CI 0.08 to 0.67, random effects model) was also observed. With respect to the preventable fraction of RTAs, it was estimated that five (NNT=5, 95% CI 3 to 8) and two (NNT=2, 95% CI 1 to 4) OSA patients should be treated with nCPAP to prevent one patient reporting real and near miss road traffic accidents, respectively.

Significance/Contribution to the Field

It seems that nCPAP treatment may offer a sizeable protective effect upon RTAs prevention. The clinical role of health professionals in accident prevention should include identification of accident risks or medical conditions conferring risk (OSA), treatment of accident-causing conditions (nCPAP treatment) and reinforcement of advocacy and policy making towards promoting accident prevention education and training (OSA patients).
DIFFERENCES IN THE PREVALENCE AND CHARACTERISTICS OF DISTRACTED DRIVING IN EIGHT COUNTRIES, 2011
Authors: Naumann R , Dellinger A
Published: October 2012

Background

Distraction is a risk factor for traffic crashes that is becoming an increasing global concern; however, its prevalence is not well documented.

Aims/Objectives/Purpose

To examine the prevalence and characteristics of those who talk or text using cellular devices while driving in Belgium, France, Germany, the Netherlands, Portugal, Spain, the UK, and the USA.

Methods

Online survey of adults aged 18–64 in the USA (N=3294) and seven European countries (N=8955), weighted to the age and sex distributions of each country. Respondents reported how often they talk on their cellular phone while driving and how often they read or send text messages or email while driving. We examined differences in prevalence by country, age group, and sex.

Results/Outcomes

More than one in four (27.3%, 95% CI 25.1% to 29.4%) US adult drivers aged 18–64 reported they ‘regularly or fairly often’ talk on their cellular phone while driving. In Europe, percentages ranged from 20.4% in Portugal (95% CI 16.5% to 24.3%) to 7.8% in the UK (5.9% to 9.7%). Additionally, 7.7% (6.3% to 9.0%) of US drivers aged 18–64 reported that they ‘regularly or fairly often’ read or send text messages or email while driving. In Europe, percentages ranged from 8.1% (95% CI 6.6% to 9.6%) in Belgium to 2.5% (95% CI 1.3% to 3.7%) in the UK. There were few differences by sex, but there were differences by age group within most countries.

Significance/Contribution to the Field

This study provides recent prevalence estimates of distracted driving-related behaviours in eight countries, which can be used to target high-risk groups for prevention efforts.
USING IN-DEPTH CRASH DATA TO ASSESS THE ROLE OF DRIVER INATTENTION AND DRIVER DISTRACTION IN CRASHES
Authors: Beanland V , Fitzharris M , Young KL , Lenné MG
Published: October 2012

Background

Driver inattention and distraction represent major challenges for road safety. Although both are believed to increase crash risk, there is currently limited information on their role in crashes.

Aims

This study aimed to investigate driver inattention and distraction in serious casualty crashes using data from the Australian National Crash In-depth Study.

Methods

The sample included 340 serious casualty crashes from 2000–2011 where a driver or passenger was interviewed. Pre-hospital, hospital and post-crash information concerning the vehicle and scene were collected. Using a ‘case-by-case’ approach, driver behaviours were classified using a recently developed taxonomy of driver inattention. Five inattention subtypes were defined: restricted attention; misprioritised attention; neglected attention; cursory attention; and diverted attention (distraction).

Results

124 crashes (36.5%) showed no evidence of inattention, 20 crashes (5.9%) involved possible inattention, and 196 crashes (57.6%) involved an element of inattention on the part of a driver. The most common inattention subtypes were restricted attention (n =128; 37.6%), in which attention is limited due to physical or biological factors (eg, fatigue, intoxication), and distraction (n =54; 15.9%). The most common distractions were voluntary, in-vehicle, non-driving related distractions (eg, passenger interactions).

Significance

The results demonstrate that the majority of serious injury crashes involve an element of driver inattention or distraction. In most cases, the type of inattention and distraction behaviours observed were preventable, highlighting the need for improved education as well as new technology solutions to aid the driver. This study also highlights the value of in-depth data in understanding crash causation.
LESSON LEARNT IN INJURY CONTROL: AFTER 30 YEARS WHAT WOULD I DO DIFFERENTLY?
Authors: Francescutti LH
Published: October 2012

Our current view of injury prevention is shallow, narrow and unfocused. We may need to re-examine our approach to injury control to include a more holistic approach that is essentially based on the social determinants of health. Injuries do not happen in isolation. Like the layers of an onion, it is a combination of interplay between various pathophysiologic pathways; constitutional factors; individual risk factors and choices; social relationships; living conditions; neighbourhoods and communities; institutions and finally social and economic policies that contribute to injury causation. From the moment we are conceived and especially up to the age of 18 months our nurturing impacts us for the rest of our lives. We have a choice to invest the time and resources when the infant's brain is most malleable or by default continue to spend too late and at a greater cost in social services, welfare, judicial systems and health care expenditures. Without a doubt, our chances of achieving greater health are directly linked to the strengthening of the social determinants of health: genetics, gender, housing, education (literacy), income and social status, personal health practices, resilience, nutrition, employment conditions, physical environment, culture, child development, spirituality and strong social support networks.

Our inability to acknowledge the importance of ‘love’ and ‘happiness’ in our lives makes the required new thinking of injuries difficult for the majority of injury prevention leaders. The current desire for instant versus delayed gratification in our society directly leads to the need for an expensive, ineffective health care system. The very actions that give usinstant gratification also give rise to disease and injury.Fatty foodsgive rise to obesity, diabetes, heart disease, and injury.Drug usegives rise to overdoses, addictions, mental illness, crime and injuries.Alcohol usegives rise to cirrhosis, mental illness, violence, injuries and crime.Inactivitygives rise to obesity, poor health, and disability.Salt usegives rise to hypertension and cardiovascular problems.Sexgives rise to sexually transmitted diseases, unwanted pregnancies, fetal alcohol syndrome and sexual assaults.Smokinggives rise to cancer, chronic obstructive pulmonary disease, bronchitis and injuries.

It is estimated that 50% of all deaths in developed countries are preventable. That for those under the age of 44, injury is the leading cause of death. For those under the age of 34 motor vehicle related injuries are the leading cause of death. And finally, injuries kill more 1–19-year-olds than all other diseases combined.

Let us broaden our approach to injury prevention by boldly linking our discussions to include ‘love’, ‘happiness’, ‘instant versus delayed gratification’ and the ‘social determinants of health’ as we search for solutions to this seemingly elusive problem—injuries.
PREVENTING VIOLENCE: GENERATING AND USING THE EVIDENCE
Authors: Butchart A
Published: October 2012

WHO, along with other United Nations organisations and international agencies working to strengthen violence prevention at national and local levels, advocates an evidence-based approach to prevent the problem of violence. The case for evidence-based approaches is an ethical one—to do as much good as possible with available resources. Without using an evidence-based approach, well-intentioned policymakers and practitioners can squander scare resources on policies and programmes that are at best ineffective and in some instances actively harmful. Drawing on reviews of the scientific literature, and using the Liverpool John Moores University—WHO online violence prevention database as an indicator of all published violence prevention outcome evaluation studies, this presentation has three aims. The first aim is to map the distribution of outcome evaluation studies by type of violence (ie, child maltreatment; youth violence; intimate partner violence; sexual violence; elder maltreatment, and self-directed violence); level of intervention (ie, individual, family, community, societal), and WHO geographical region. The second aim is to map progress in implementing the four stages of the public health approach to violence prevention (ie, problem description, risk factor identification, intervention evaluation, and scaling up) by country income level and type of violence. The third aim is to suggest priority actions for generating and using scientific evidence for the prevention of violence.
FALLS IN YOUNG AND WORKING AGE ADULTS—SHOULD WE BE WORRYING ABOUT THEM?
Authors: Kool B
Published: October 2012

Falls research and prevention efforts have traditionally focused on the very young and very old. But what about falls in young and middle-aged adults are they an issue? Do people suddenly stop falling when they become young adults and not start again till they reach advancing years?

This presentation will focus on how common falls are in young and middle-age adults. The characteristics and contexts of falls in this age group will be discussed. Knowledge of factors that increase risks of having falls in this age group, and factors that predict poor outcome following falls will be presented. Finally opportunities for prevention will be debated including whether young and middle-aged adults think falls are a problem, what evidence is there that anything works, and where might future opportunities lie.
Understanding unintentional childhood home injuries: pilot surveillance data from Karachi, Pakistan
Authors: Nukhba Zia , Uzma R Khan , Junaid A Razzak , Prasanthi Puvanachandra , Adnan A Hyder
Published: October 2012

Background

Childhood injuries, an important public health issue, globally affects more than 95% of children living in low-and middle-income countries. The objective of this study is to describe the epidemiology of childhood unintentional injuries in Karachi, Pakistan with a specific focus on those occurring within the home environment.

Methods

This was a secondary analysis of a childhood unintentional injury surveillance database setup in the emergency department of the Aga Khan Hospital, Karachi, Pakistan for 3 months. The data was collected by interviewing caretakers of children under 12 years of age presenting with an unintentional injury to the emergency departments of the four major tertiary care hospitals of Karachi, Pakistan.

Results

The surveillance included 566 injured children of which 409 (72%) injuries had taken place at/around home. Of 409 children, 66% were males and mostly between 5 and 11 years of age. Injuries commonly occurred during play time (51%). Fall (59%), dog bites (11%) and burns (9%) were the commonest mechanisms of injury. The majority of the children (78%) were directly discharged from the emergency room with predicted short term disability (42%). There were two deaths in the emergency department both due to falls.

Conclusion

Childhood injury surveillance system provides valuable in-depth information on child injuries. The majority of these unintentional childhood injuries occur at home; with falls, dog bites and burns being the most common types of unintentional childhood home injuries.

Significance

Specific surveillance systems for child injuries can provide new and valuable information for countries like Pakistan.
Be more careful: a national programme for the prevention of domestic accidents in the elderly
Authors: von Amann G Paixão , Silva I
Published: October 2012

Background

Within the scope of the National Programme for Safety Promotion and Injury Prevention, domestic accidents are a major public health concern. In Portugal, injuries have a prevalence of 75% in people aged 65–74 and 90% in those aged over 75. Most accidents occur at home and falls are their major cause.

Methodology

The Directorate-General of Health in partnership with MAPFRE Foundation established a national capacity-building, step-by-step Plan. The 1st step was the issue of a Guide for the professionals and leaflets for the elderly. The 2nd step consisted of training sessions on ageing and promotion of enabling environments.

The 3rd step was the implementation of a website, where the Health Centres can record their projects. The 4th step aimed at improving checklists in order to evaluate the house safety conditions, the individual risk of falls and at establishing a daily physical exercise programme. Finally, in the 5th step, a professional Theatre Company performed a plays on prevention of domestic accidents.

Outcomes

All health professionals that attended training sessions acquired special skills and competences. Everyday new projects are emerging from the North down to the South of Portugal. From October 2011 till now (June 2012) wehave register on line 20 projects that are supporting 4800 people aged 65 and more that benefit of health evaluation, home evaluation and training programmes of physical activity.

Conclusions

Although project are quite different from each other, they have in common a diagnosis involving older generations, clear objectives, measurable targets and final evaluation. Elderly supported by the project are MORE CAREFUL and falls reduced significantly. Working with the community, involving public and private partners is crucial for the sustainability of the project.
Victims of domestic injuries and suicide among women of reproductive age in Iran
Authors: Mohammadi R , Sadeghi-bazargani H , Fardiazar Z
Published: October 2012

Background

As a part of a national home safety programme in Iran, a surveillance system was designed and implemented in the whole country (especially in rural areas) to register those injuries which resulted in an emergency room visit.

Aims/Objectives/Purpose

The aim of this study was to map out some epidemiological aspects of self inflicted and unintentional injuries among Iranian women at reproductive age using the national registry.

Methods

Injury data were taken from a national-based injury surveillance system over the period 2000–2002. The study population comprised 31.5% of Iran's population.

Results/Outcomes

Of all the 307 064 home injuries reported during the years 2000–2002, about 152 600 cases (49.7%) involved women. About half of these women (76,474) belonged to reproductive age. The majority (42.7%) of injuries among reproductive age women were burn wounds followed by lacerations in 32.6%. Eighty-five percent of suicide cases were poisonings followed by 11% of cases being due to burns. However, 45.2% of burn suicides were fatal compared to only 0.89% fatality ratio for poisoning. Of all women victim cases, 1029 died, 174 victims became disabled and the remaining improved or were undergoing therapy when reported.

Significance/Contribution to the Field

Injuries especially burns are a major health problem for women at reproductive age in Iran and should be considered as a priority for prevention measures.

In addition, the surveillance system employed in this study can be discussed as a practical model for Low and Middle income countries.
Caretaker perceptions of childhood home safety and injury risks in Karachi, Pakistan: a qualitative study
Authors: de Ramirez S Stewart , Khan U , Chandran A , Zia N , Huang C , Razzak J , Hyder A
Published: October 2012

Background

Over 875 000 deaths occur annually in children under the age of 18 due to unintentional injuries. Children under 5 years spend the predominant part of their day at home—an environment that poses the greatest amount of risk for their safety. Despite this risk, home-based injury prevention campaigns are primarily a westernised concept. Understanding caretaker perceptions of home safety and injury risks in low-income countries is central to effective prevention efforts.

Aims/Objective/Purpose

The objective of this study was to understand caretaker perceptions of childhood home safety, injury risk, and optimal mechanisms for dissemination of childhood home safety prevention information in Karachi, Pakistan.

Methods

In-depth interviews and focus group discussions were conducted with caretakers in multiple communities in Karachi, Pakistan. Data were coded by two independent coders, themes were identified, and a theoretical framework was developed.

Results/Outcome

Thirty in-depth interviews and ten focus group discussions were conducted. Caretakers correctly identified risk factors and home safety hazards; however, they noted several barriers to addressing them such as financial hardship, lack of decision-making power as women, pressure from extended family living in the household, and lack of simple safety solutions. Caretakers felt that community campaigns via TV/radio could help change household attitudes toward prioritising child safety.

Significance/Contribution to the Field

Caretakers in low-income countries like Pakistan are aware of home injury risks and safety hazards for children under 5; however, lack of community awareness and financial constraints make change difficult. Social campaigns should target decision-makers within households and emphasise low-cost solutions.
Safe trampolining—a persistent challenge
Authors: Ashby K , Cassell E
Published: October 2012

Background

Trampolines are associated with 1100 hospital-treated child injuries annually in Victoria, almost two-thirds of which occur in home backyards. In the United States the American Academy of Paediatrics called for a ban on domestic trampolines. The Australian response was more measured and a revision of the Australian Standard was undertaken to reduce the risk of injury. A revised Standard concentrated on safety aspects such as spring padding design, protection of sharp edges, safety marking/labelling and mandated a minimum level of consumer safety information. It was expected that these measures would show a reduction in trampoline-related injury. Contemporaneously, trampolines that have a safety net have come on the Australian market.

Aims/Objectives/Purpose

The aim of this study is to investigate trends in hospital-treated trampoline injury in Victoria, during the period July 2002 to June 2011.

Methods

Hospital admissions for injuries involving trampolines were extracted from the Victorian Admitted Episodes Dataset, while non-admitted cases were extracted from the Victorian Emergency Minimum Dataset.

Results/Outcome

Falls from trampolines increased by 98% in the study period, increasing yearly despite intervention. Most injury to children occurred in the domestic setting.

Significance/Contribution to the Field

Anecdotal evidence from suppliers and manufacturers indicate substantial increase in the sale of new trampolines in recent years, after the introduction of new product styles. Therefore it is likely that trampoline usage levels have likewise increased over the 9 year period, which may account for some or all of the observed increase in frequency. High quality surveillance data is required to determine in injuries are associated with new style trampolines.
Fire and burn risks to children: exploring the role of housing quality
Authors: Gielen A , Shields W , McDonald E , Frattaroli S , Bishai D , Ma X
Published: October 2012

Background

The increased risk to low income, urban children from fire and burn injuries is well documented. However, little is known about how housing quality affects young children's injury risk, even though the majority of their injuries occur in and around the home in the US and globally.

Aims

To describe the frequency and characteristics of substandard housing in homes with young children; and to examine the association between substandard housing and the presence of working smoke alarms and safe hot water temperatures.

Methods

In-home observations were made in 246 homes in low income urban neighbourhoods in Baltimore, MD using 46 items from the US Housing and Urban Development's Housing Quality Standards form.

Results

Virtually all homes (99%) failed the housing quality measure. Items with the highest failure rates were those related to heating and cooling systems; wall, ceiling and floor conditions; and sanitation and safety issues. Only 42% of the homes had a working smoke alarm on every level of the home; 62% had safe hot water temperatures. Logistic regression analyses found that the odds of having a working smoke alarm on every level increased by 18% and the odds of having safe hot water temperatures by 8% for every one item increase in the number of housing quality items passed.

Significance

These results demonstrate that many low-income children may be at heightened risk for fire and scald burns simply by virtue of living in poor quality housing. Stronger collaboration between housing and injury prevention professionals is urgently needed.
Application of a new instrument to measure injuries and disability at the Iganga-Mayuge demographic surveillance system (im-dss), Uganda.
Authors: Bachani AM , Hyder AA , Kadobera D , Galiwango E , Rutebemberwa E , Bishai D , Wegener S , Morrow RH
Published: October 2012

Background

Millions of injured individuals survive worldwide each year, often with life-long disabilities. However, the measurement of post-injury outcomes, especially in low-income settings remains a major deficiency in health information systems.

Aims/Objective/Purpose

We apply a new short, 8-question instrument to screen for injuries and disabilities at the IM-DSS in Uganda.

Methods

We utilised a modified version of the short set of questions proposed by the Washington Group on Disability Statistics. Information on injuries sustained within the prior year, and activity limitations was collected on all individuals over the age of 5 who were residents of the IM-DSS.

Results/Outcomes

57 247 individuals were included in the survey. 596 individuals reported having had an injury (62% Male; 38% Female). Of these, the majority were Road Traffic Injuries (41%), followed by falls, blunt injuries, and burns. Individuals between the ages of 15–59 years accounted for more than half of all injuries. 82% of injured persons also reported having a disability (OR 61; 95% CI 47.9 to 77.7; p<0.001). The most common types of difficulties reported were vision and mobility (lower and upper mobility).

Significance/Contribution to the Field

This study shows that the modified short set of questions can be readily applied to obtain estimates on the prevalence and types of post-injury disability at the population level—a step towards understanding the long-term consequences of injuries and the type of care needed to address them in the population. This instrument could be adapted for use in other such settings allowing for comparable estimates across different regions and populations.
Patient outcomes following traumatic fracture of the femoral shaft. Does surgical approach influence outcomes?
Authors: Gosling C , Richardson M , Brown G , Hau R , Pirpiris M , Edwards E
Published: October 2012

Background and Aim

Lower limb fractures are often associated with poorer patient outcomes. The aim was to describe the 12-month outcomes of bony union, complication rates, health related quality of life (HRQL) and pain following femoral shaft fractures in a trauma registry based cohort.

Methods

Data for all patients with an ICD-10 injury code for femur, below the level of neck, admitted between May 2005 and June 2009 were obtained from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) database. Data were collected at baseline (patient, injury, x-ray and hospital record details) and 12-months (bony union, complications, pain and HRQL—short form-12 (SF-12) summary scores for physical and mental component summary (PCS-12, MCS-12).

Results

417 femoral shaft fractures (AO-32) were identified in 403 patients (70% male; average (SD) age=37.6(20.6) years). Transport crashes were the most common cause of injury (66%). Simple femoral fractures (51%) were the most common type. Most patients underwent fixation using an antegrade femoral nailing approach (62%). Fracture union was confirmed in 231 patients (average time: 196.5 days), although 45% and 12% demonstrated non-union at 6 and 12-months respectively. 23% of the reviewed cases underwent further femoral surgical intervention including implant exchange, dynamisation and/or bone grafting. There was no association between fixation approach and pain or bone union. The antegrade group had better 12-month physical function scores (PCS-12) (p<0.001).

Significance

The high rate of delayed union, and the requirement for further surgical intervention in this registry based cohort warrants further investigation in the real world environment.
Thirty day outcomes of severe injuries in patients presenting to the emergency departments of two public tertiary care hospitals in Sindh Pakistan
Authors: Razzak J. , Kalhoro S.
Published: October 2012

Background

Post traumatic mortality and morbidity (PTM&M) is different between different designated hospitals so studies should be done to assess the difference in PTM&M between similar designated hospitals

Objectives

To assess the difference in the rate of death and disability at 30-days among patients aged ≥14–80 years with history of severe injuries presenting at ER of two public tertiary care hospitals in Sindh Pakistan. To identify risk factors for death and disability due to severe injuries among patients aged ≥14–80 year presenting to the ER of two public tertiary care hospitals in Sindh Pakistan.

Methodology

Study design: longitudinal cohort

Sample size: 390 eligible participants

Study follow-up: 30 days

Study site: civil hospital Karachi and Hyderabad

Data collection tools: Baseline Questionnaire and SF 36 for disability

Statistical analysis: Rate ratio, rate difference and logistic regression

Results

By taking Hyderabad as reference, there was no significant difference in incidence rate of mortality (rate ratio 1.12 (95% CI 0.77 to 1.63)) (rate difference 14 (−33, 61)), incidence rate of physical disability (rate ratio 1.01 (95% CI 0.67 to 1.51)) (rate difference 0.88 (−44, 46)) and incidence rate of mental disability (rate ratio 0.69 (95% CI 0.40 to 1.21)) (rate difference −220 (95% CI −556 to 115)) injury severity, patients attended by paramedics as compared to doctors in the ER and delay to receive general management were associated with mortality. Lower extremity injury and higher hospital stay were associated with worse disability.

Conclusion

Incidence rates of mortality and disability were not different between two tertiary care settings but overall incidence rate of death and disability was higher in severely injured