bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of road traffic injuries in drivers in a rapid highly economically developing country: a major global public health crisis
Authors: Bener A , Burgut H R , Sidahmed H , AlBuz R , Sanya R , Khan W Ali
Published: March 2011

Aim

The objective of this study was to determine the characteristics of road traffic injuries (RTIs) among Qatari drivers and examine the human behavioural and environmental risk factors associated in occurrence of RTIs.

Design

This is a cross sectional survey.

Setting

Primary Healthcare Centers in the State of Qatar.

Methods

This study was conducted during the period of February–July 2009. A random sample of 1800 Qatari drivers was approached and 1406 drivers responded and agreed to participate in this study, with a response rate of 78.1%. Face to face interview was conducted by well-trained research assistants based on a questionnaire covering socio-demographic information, driving history, type of vehicle, driver behaviour, severity of injuries and nature of injuries.

Results

The study revealed that of the studied Qatari drivers (1406), 14.5% of them were injured. Young drivers in the age group 25–34 years were more involved in RTIs (35.8%). The RTIs occurred more among male drivers than females with the ratio 1.7:1 (p<0.001). Overall, 53.9% of the studied Qatari drivers were injured from traffic violations, especially with exceeding speed limit (25.9%) and parking violation (18.1%). 28.4% of the injured drivers were distracted with eating or drinking and 25% using mobile phone. Qatari drivers were more injured from overturn skid crashes (20.6%) and hitting fixed objects (14.7%). Head injuries were reported more from light vehicle crashes (33.3%) and neck injuries from Pickup and SUVs crashes (44.7%). Severe injuries were reported among Qatari drivers who had heavy vehicle crashes (43.5%).

Conclusion

The study findings revealed the high risk of RTIs was among young male Qatari drivers in the age group (25–34) years. It showed that human behavioural factors represent one of the main causes of RTIs such as excessive speed and using seatbelt. Head and neck injuries were reported more among Qatari drivers.
Analysis of fatal bus crashes in Bangalore, India
Authors: Gururaj G
Published: March 2011

Growth of motor vehicles and infrastructure expansion are hall marks of transport development in the last decade in India. Public transport buses in Bangalore city has increased from 2300 in 2002 to 5300 by 2009 with expansion of coverage, trips and users, with a corresponding increase in road crashes and deaths.

The study is part of the ongoing Bangalore Road safety and Injury Prevention Programme. The objectives were to examine (1) the contribution of public transport buses in road crashes and (2) crash characteristics of collisions involving buses. Data collection were undertaken from records by trained personnel.

On an average, 100–120 buses are involved in fatal collisions and 400–500 in non-fatal crashes every year, with an increase of deaths from 58 in 2000 to 113 in 2008. Nearly 85% of crashes and deaths with public buses occurred within the city/municipal roads and in 12 major geographical areas. Nearly 1/3 of deaths occurred at the crash site, 22% during transportation and 44% in the hospital. Three of four deaths included road usears of <35 years and involved pedestrians (28%), two wheeler riders (40%) and bus occupants (16.3%). Young drivers (<25 years) were involved in more crashes with median age of fleets being 8.3 years. Several risk factors in vehicles, roads, environment and among road users were identified.

Public transport systems have a major responsibility and needs to have scientifically developed policies and programmes to ensure safety of citizens, both inside and outside vehicles.
A predictive screener for depression & PSTD after physical injury
Authors: Richmond T S , Ackerson T , Ruzek J , Wiebe D , Winston F , Kassam-Adams N
Published: March 2011

Aim

To develop a predictive screener that will accurately predict the future development of postinjury depression or post-traumatic stress disorder (PTSD).

Methods

A prospective, longitudinal cohort study of subjects randomly selected from patients requiring an Emergency Department (ED) visit for injury. A theoretically and empirically derived 45-item risk survey was administered soon after injury. A psychiatric diagnostic interview was conducted at 3 and 6 months to determine emergence of depression or PTSD. Multiple logistic regression analyses were performed separately for depression and PTSD, using a best-subset approach to select models at each step by comparing log-likelihood estimates.

Results

Of 175 (of 192 enrolled) available for follow-up, 16% developed depression and 2.3% developed PTSD. A logistic model retaining four depression items and five PTSD items emerged. One item predicted both depression and PTSD; hence the final screener is eight items. Receiver operating characteristic for depression and PTSD was 0.81 each. Optimal cut-off scores were >2 (out of 4) for depression and >3 (out of 5) for PTSD. Depression findings: sensitivity 0.81, specificity 0.71, PPV 0.34, NPV 0.95. PTSD findings: sensitivity 1.00, specificity 0.66, PPV 0.07, NPV 1.00.

Conclusions

Thirty million seek ED care annually for injury and a significant subset develop psychiatric disorders that that impede recovery. The high NPV for both depression and PTSD supports the role of this new instrument as a short, clinical screener: those who screen negative can be screened out from further monitoring, allowing precious resources to be focused on those at highest risk for the development of depression and PTSD.
Incidence and mortality of burn injuries in Sulaymaniyah, Iraq
Authors: Othman N , Kendrick D
Published: March 2011

Background

Little is known about burns in Iraq. This study was undertaken to investigate epidemiology of burn injuries in Sulaymaniyah province with 1.7 million people.

Methods

A prospective study from November 2007 to November 2008 involving all patients attending for a new burn injury.

Results

2975 patients were recruited (male 52%, female 48%; median age 18 years). All-age incidence of burns was 389/100 000 person-years (pys) and 1044/100 000 pys in preschool children. The mechanisms of injury included scalds (53%), flame (37%), contact (7%), chemical (1%), electrical (1%) and explosives (1%). Most burns occurred at home (83%; male 68%, female 96%). There were 884 admissions (43/100 000 pys) with a significantly higher admission rate in females (males 37, females 49) and the highest rate in preschool children (95/100 000 pys). Flame injuries accounted for most women admissions (91%) and scalds for most child admissions (84%). Overall mortality was 8/100 000 pys (males 2, females 14). Median total body surface area (TBSA) burnt was 18% and median hospital stay was 8 days. In-hospital mortality was 28%. Adjusted ORs for death were 36.4 (95% CI 15.9 to 83.3) for TBSA burnt ≥40%; 5.4 (95% CI 1.7 to 18.5) for age of 60 and over; 3.6 (95% CI 1.7 to 7.3) for inhalation injury; 5.6 (95% CI 2.5 to 12.9) for self-inflicted burns and 3.0 (95% CI 1.3 to 6.8) for autumn season.

Conclusion

Burns are an important public health problem in Sulaymaniyah with higher morbidity in children and mortality in women. Preventive interventions are needed focusing on childhood scalds and flame injuries in women.
Risk factors for burns in preschool children in Sulaymaniyah, Iraq: a case–control study
Authors: Othman N , Kendrick D
Published: March 2011

Background

Young children are at a higher risk of burns. This study was undertaken to investigate risk factors for burns in preschool children in Iraq.

Methods

A prospective case–control study in 2008 involving children aged 0–5 years. Cases comprised hospital attenders with a burn injury occurring at home and controls comprised hospital admissions for other conditions, matched on age and sex. Analysis was undertaken using multiple logistic regression.

Results

248 cases and 248 controls recruited. 79% of cases were scalds, 17% contact and 4% flame injuries. Burns most commonly occurred in sitting rooms (53%) and the kitchen (36%) and were most commonly caused by tea utensils (42%) and kerosene stoves (36%). The adjusted ORs for risk factors for burns were 5.4 (95% CI 2.6 to 11.7, p=0.001) for poor living standard; 5.3 (95% CI 3.4 to 8.5, p=0.001) for child activity score; 2.8 (95% CI 1.5 to 5.2, p=0.02), for family history of burns; 1.32 (95% CI 1.02 to 1.70, p=0.04) for unit increase in presence of home hazards; 0.4 (95% CI 0.2 to 0.7, p=0.002) for presence of a second carer; and 0.14 (95% CI 0.03 to 0.60, p=0.008) for presence of disabilities.

Conclusion

Poverty, child activity, home hazards, family history and absence of a second carer are significant risk factors for childhood burns. Preventive interventions addressing poor families and focusing on home safety could be effective in reducing childhood burns.
The development of the educational theme of the trauma prevention at Japanese high school students
Authors: Kojima Y , Kenmochi I , Kojima H , Yamazaki S , Kuroda K , Yokoyama M
Published: March 2011

In Japan, the cause of death between the age of 15 and 19 due to suicide and incidents were 60.2% in 2008. Even though high school students tend to be overly concerned about their own physical well-being, especially in regards to external injuries, they tend to exhibit a low interest in personal prevention and little knowledge of Safety and Risk Management. Therefore, PARTY (Prevent Alcohol and Risk-related Trauma in Youth) Isehara, established Traffic and Sports External Trauma Prevention classes to be taught at the high school level in Japan. The classes are designed to prevent trauma that they, the students may inflict upon themselves or others as well as to help those in need of assistance. To enhance student interest in External Trauma Prevention, PARTY Isehara conducted a content analysis study asking students to define and explain external trauma in their own words. The purpose of the study was to determine the level of motivation of the high school participants for 2006–2009. The results indicated that the students were highly interested in not only physical external trauma, but also mental external trauma. Furthermore, the students were especially drawn to human relationship matters concerning friends and their school, as well as situations of external trauma in terms of the perpetrator, victim and third person. Moreover, the students were able to identify places of risk going to and from school, although they were unwilling to share details pertaining to that particular data.
Motorcycle injuries across the USA, 2001–2008: injury comparisons and projections
Authors: Naumann R B , Dellinger A M , West B A , Annest J L , Ryan G
Published: March 2011

Background

In 2008, motor vehicle occupant deaths in the USA declined to their lowest level in the last three decades, while motorcyclist deaths increased to an all time high, more than doubling in the last 10 years.

Objectives

To estimate the number of emergency department (ED)-treated non-fatal motorcyclist injuries in the USA between 2001 and 2008, describe important characteristics of these injuries, compare rates of non-fatal to fatal injury, and project the number of ED-treated motorcyclist injuries that may be observed in 2010 and 2020.

Methods

Data were obtained from the National Electronic Injury Surveillance System-All Injury Program for the years 2001 through 2008. Injuries were categorised by body part primarily affected, primary diagnoses, and ED discharge disposition. Weighted estimates and rates were calculated, and linear regression was used to estimate the number of future motorcycle injuries.

Results

Between 2001 and 2008, an estimated 1 221 690 persons were treated in a USA ED for a non-fatal motorcycle injury. The highest injury and death rates occurred in the 20–24-year-old age group. Motorcycle death rates increased 50% from 1.29 per 100 000 persons in 2001 to 1.94 per 100 000 persons in 2008. ED-treated non-fatal motorcyclist injuries also displayed an increasing trend, and preliminary projections indicate these injuries may nearly double again from 170 000 to 320 000 annual injuries between 2008 and 2020 given current trends.

Discussion

Reversing the increasing trend of motorcyclist injury, death and cost across the USA will take a concerted effort among traffic safety and public health practitioners, the medical community and policymakers.
Epidemiology of overuse injuries among intercollegiate athletes
Authors: Yang J , Cheng G , Nayar S , Tibbetts A , Heiden E
Published: March 2011

Objective

Research on overuse injuries has been limited among collegiate athletes. This study describes the epidemiology of overuse injuries sustained by Division I intercollegiate athletes.

Methods

Injuries were identified using an ongoing injury surveillance system established for Big Ten Athletic Conference universities. A total of 1333 injuries from 21 sports teams at one university during the study period (2005–2008 seasons) were analysed. The injury type, body region and games or practices missed due to the injury were described. Injury rate was calculated as the total number of overuse injuries divided by the total number of athlete-exposures during the same period.

Results

A total of 387 overuse injuries (29% of all injuries) were reported during the study period, with 238 (61.5%) for females athletes and 149 (38.5%) for male athletes. The rate of overuse injuries was 18.5 per 10 000 athlete-exposures. Females had a higher overuse injury rate than males, with rate of 24.6 versus 13.3 per 10 000 athlete-exposures. The highest overuse injury rates were observed in women field hockey, softball, women soccer and volleyball, with rates of 70.5, 56.7, 48.3 and 42.6 per 10 000 athlete-exposures, respectively. The most frequent injured body region was lower extremities. The most common injuries were general stress, inflammation and tendinitis.

Conclusion

Further analysis is needed to better understand why female athletes are at higher risk of overuse injuries. Effective interventions to prevent and treat these injuries are also warranted.
Injuries to adult cyclists in Toronto and Vancouver: describing the circumstances as a first step towards injury prevention
Authors: Babul S , Frendo T , Winters M , Brubacher J R , Chipman M L , Chisholm D , Cripton P A , Cusimano M D , Friedman S M , Harris M A , Hunte G S , Reynolds C C O , Teschke K
Published: March 2011

Introduction

Bicycling is a sustainable mode of transportation with health benefits, but the risk of injury deters many people. We studied injured cyclists from two urban areas to characterise injury severity and mechanism.

Methods

Multicentre case-crossover study. Adult cyclists who visit emergency departments in three Toronto and two Vancouver hospitals are being recruited. Canadian Trauma and Acuity Score (CTAS) data are retrieved from hospital records. Descriptive data and comparisons of the first 300 injury events, 150 in each city, are presented.

Results

The median CTAS score was 3 (IQR: 3–4; n=228). Of the 300 cyclists studied, 27 (9.0%; 95% CI 5.8 to 12.2%) were admitted to hospital. Injury mechanism was classified as a collision in 213 cases (70.9%; 65.9–76.1%) or fall in 87 (29.1%; 23.9–34.1%). Collisions involved motor vehicles in 102 cases (34.1% of all events; 28.6–39.4%), streetcar/train tracks in 46 (15.4%; 10.9–19.0%), curbs/fences/barriers in 38 (12.7%; 8.3–15.7%), pedestrians/other cyclists in 14 (4.7%; 2.3–7.1%), potholes in 9 (3%; 1.1–4.9%) and animals in 3 (1%; 0–2.1%). Manoeuvres to avoid collisions resulted in 28 falls (9.3% of all events). The proportions of injuries involving motor vehicles were almost identical in the two cities, but the odds of an event involving dooring were higher in Toronto than Vancouver (OR 2.83, 95% CI 1.13 to 7.02). Toronto events were more likely to involve streetcar tracks (OR 19.6, 5.9 to 65.0) and less likely to involve pedestrians or cyclists (OR 0.33, 0.13 to 0.83) than those in Vancouver.

Conclusions

Injury circumstances and differences between cities suggest that transportation infrastructure and interactions with motorised and non-motorised traffic are important factors in cycling injuries.
Review of child road injury prevention initiatives
Authors: Chalmers E
Published: March 2011

This paper summarises results and recommendations from a 20 country survey of road-related child injury prevention initiatives from around the world. The WHO/Unicef report on child injuries confirmed the horrific toll from childhood injuries across the world, especially road trauma. On the other hand, child injury prevention is a complex objective and very much depends on the environment and social context in which the intervention takes place. The survey is based on two components A seven country study tour late 2009 by the author, supported by a Winston Churchill Memorial Trust research Fellowship; and a 12 country survey of other member countries of the Safe Kids Worldwide network of child injury prevention organisations. This material will then be compared and analysed to identify common themes, successes, failures and lessons learnt from past interventions; potential for and limitations on transferring experiences in one environment into other environments; Potential strategies that the collective experience of participating countries indicate will improve future outcomes; and Common ground and the potential for the effective integration of injury prevention initiatives across injury causes and over time to improve injury outcomes for children. The author is Chief Executive of Kidsafe (the Child Accident Prevention Foundation of Australia) in Canberra and Chair of the Network Advisory Council of the Safe Kids Worldwide network. He has a long background in child injury prevention, management consulting and industry regulation.
Occupational road safety worldwide: lessons for research, policy and practice
Authors: Pratt S , Murray W , Townsend E , Jackson L L
Published: March 2011

In February 2009, National Institute for Occupational Safety and Health (NIOSH) and partners hosted the first International Conference on Road Safety at Work, identifying the following for 200+ participants from 44 countries.

Occupational motor vehicle crashes affect a substantial proportion of road and worker fatalities, meaning that occupationally focused initiatives can be highly significant.

There is a consensus for the need to adopt a systems-based approach to at-work road safety, engaging all stakeholders.

At the macro level, purpose of journey should be identified in road safety statistics, and on-road incidents should be included in health and safety datasets to guide policy, regulation and enforcement. Government leadership is also required by to manage the safety of their own employees.

At the organisational level, it is important to make the business case for road safety and to ensure collection of data for baseline assessment and monitoring progress. These activities should be guided by a systems-led, risk-based approach and supported by rigorous evaluation.

Further efforts are required to link research and practice, and continue to engage governments, researchers, practitioners and NGOs around the globe.

Follow-up activities in Europe (already taking place through the ETSC PRAISE project), Asia, Africa and the emerging BRICK economies can sustain the energy and momentum generated by NIOSH.

This paper describes these outcomes in detail, making recommendations for researchers, policy makers and practitioners; and identifying how barriers to success can be overcome, based on the conference white paper, proceedings and PRAISE project reports, including good practice cases from around the world.
Injury Prevention News (IPN): a free e-newsletter for the UK and Ireland
Authors: Verne J , Brown P , Slater W , Towner E , Bellis M A , Anderson Z , Hughes K , Lyons R A , Turner S , Shepherd J , Barron S , Stone D , Fischbacher C , Lumsden E , Pollock A , Kirkwood G
Published: March 2011

Injury Prevention News (IPN) is a free electronic newsletter produced jointly by the Injury Observatory for Britain and Ireland (IOBI;http://www.injuryobservatory.net) and the Collaboration for Accident Prevention and Injury Control (CAPIC;http://www.capic.org.uk).

The purpose of IPN is to support injury prevention practitioners working in all areas of injury prevention and dealing with all age groups. IPN is a free source of information on new initiatives, statistical publications, research findings, forthcoming conferences and events, and also highlights new additions to the IOBI and CAPIC websites. Although IPN focuses on injury prevention work in the UK and Ireland, it also includes research from around the world.

If you would like to receive IPN it can be downloaded freely from either the IOBI or CAPIC websites, or you can subscribe to IPN at the following web addresshttp://www.injuryobservatory.net/sign_up.html. IPN currently has more than 200 people subscribed from around the world, with many organisations helping to promote IPN by including information in their own e-bulletins and newsletters. IPN is produced three times yearly with editions in January/February, May/June and October/November.

For further information or to submit content towards the newsletter please contact Samantha Turner ats.turner@swansea.ac.uk.
Global injury surveillance opportunities and challenges
Authors: Mello M J , Pressley J , Stephens-Stidham S , Annest J Lee , Fingerhut L A
Published: March 2011

Throughout the world opportunities and challenges exist for injury surveillance including system establishment, methodology of data collection and data dissemination. Despite differences in culture and environment, there remain many common challenges to conducting injury surveillance and missed opportunities for sharing cross-national solutions that address these. This interactive workshop will utilise a panel of global injury experts to discuss strengths and limitations of existing strategies, as well as lessons learned and their applicability in different settings. Three distinct topic areas will be covered by two expert panelists for each area. Topics and panelists include: (1) methodology for population-based injury surveillance depending on available resources with Yvette Holder, International Injury Surveillance Consultant, St Lucia; Holly Hedegaard, Colorado State Department of Health, USA; (2) garnering resources and political will to create an injury surveillance infrastructure with Kidist Bartolomeos Department of Violence and Injury Prevention, WHO, Geneva; and Susan Scavo Gallagher, Tufts University, USA; and (3) providing timely access to surveillance data for use in injury prevention efforts with Lee Annest, Centers for Disease Control and Prevention, USA; and Andres Fandino, CISAVLA Institute, Colombia. The moderator, Joyce Pressley, PhD, MPH (American Public Health Association/Injury Control and Emergency Health Services Section), will ask panelists pre-assigned questions following which the audience will have the opportunity of asking questions related to each of the topics. Panelists in each area will be encouraged to provide case examples from countries of varying resources.
Estimated out of pocket medical and work loss expenses due to road traffic injuries in Karachi, Pakistan
Authors: Bhatti J A , Ali M , Khan U R , Razzak J A
Published: March 2011

Introduction

Over 35 000 road traffic injuries (RTIs) were reported in Karachi in 2007. The aim of this study was to assess out of pocket medical and work loss expenses due to RTIs in Karachi.

Methods

In this cross-sectional study, randomly selected RTI patients in one of the five teaching hospitals in Karachi in 2007 were contacted by phone regarding their out of pocket medical expenses, monthly income and time spent in hospital due to RTI. Reported information was then used to estimate costs for RTIs occurring in Karachi in 2007.

Results

Out of 341 RTI victims, 88% were aged 18–45 years and were men (95%). Two wheelers accounted for majority of injuries (77%, N=256) whereas 14% (N=48) were pedestrians. Twelve patients (3%) died as a result of their injuries, half of which were pedestrians while the others were two wheelers. For each mild (65%), moderate (20%) and severe injury (15%), on average US$18 (SD=127), US$245 (SD=295), US$395 (SD=394) were spent respectively as out of pocket medical expenses. Similarly work loss expenses were on average US$9 (SD=21), US$21 (SD= 124) and US$54 (SD=108) for mild, moderate and severe injury, respectively. We estimated that out of pocket medical and work loss cost were 4.7 and 1.4 million US$, respectively, in Karachi.

Conclusion

In Karachi where approximately 2.7 million persons earn less a dollar a day and 11.7 million earn less than US$2 a day, prevention of RTIs should be a given a high priority.
Screening for intimate partner violence in healthcare in Kano, Nigeria: extent and determinants
Authors: John I A , Lawoko S , Svanström L
Published: March 2011

Introduction

The adverse health consequences of domestic violence have led to increased call to involve healthcare providers in the management of partner violence prevention through screening for it within the healthcare.

Objective

To assess the extent and determinants of screening for Intimate Partner Violence (IPV) at Aminu Kano Teaching Hospital, Kano, Nigeria.

Method

274 healthcare providers responded to the domestic violence healthcare provider survey probing the frequency of screening for IPV, staff attitudes towards domestic abuse, perceived self efficacy in screening, availability of support networks and staff/patient safety in regard to IPV inquiry. t-Test and logistic regression were employed to study determinants of screening.

Results

Majority of participants (74%) had not screened for IPV during the preceding 3 months. Male gender, being elderly and of Yoruba ethnicity increased the likelihood of screening. With increasing perceived efficacy and increasing blame of the victim for abuse, the likelihood of screening for IPV increased.

Conclusion

Barriers to effective screening of IPV may emanate from the attitudes of healthcare provider towards IPV and demographic and occupational characteristics of healthcare providers. The findings have important implications for further training of specific healthcare providers with considerations to their ethnic belongings.
Patterns of severe work-related injuries in Tanzania: call for new approach to workers protection in developing countries
Authors: Kishashu Y M , Franzblau A , Robins T , Smith G
Published: March 2011

Background

Work-related injuries affect people in their most productive years. Globally more than 5500 workers are killed by injuries and illnesses every day, and more than 270 million workers are injured at work each year (ILO, 2009).Severe work-related injuries and the resulting adverse socioeconomic impacts, represent a special burden to developing countries. This study, which was conducted in Tanzania, sought to describe patterns of severe traumatic work-related injuries; identify their causes and risk factors; evaluate the quality of reporting work-related injuries and; identify strategies for their prevention and control in Tanzania and other developing countries.

Methods

Data was collected through structured interviews with 1385 injury cases admitted in the largest trauma hospital in Tanzania from March 2007 to March 2008. Detailed information was collected after work-relatedness of a case was established. Information from interviews was linked with hospital records, workers compensation and police data.

Findings

A total of 638 (46%) injury cases were classified as work-related injuries, and majority were male-workers (93%). Linkage identified 138 (10%) cases that were initially not identified as work-related. Peak age-group for both sexes was 2635 years. Road traffic injury was the most common reason for admission (62%) followed by falls (15%). Road was the leading place of injury (64%) followed by work premises (27%).

Conclusions

The study revealed new patterns of work-related injuries in Tanzania. Road traffic safety becomes an important component of workers safety in Tanzania and other developing countries.
Mapping of injuries from interpersonal violence using Geographical Information System (GIS) in an Emergency Department
Authors: Faergemann C , Rasmussen K H , Lauritsen J M
Published: March 2011

Background

Emergency departments (ED's) in Denmark are now on the verge of routinely using Geographical Information System (GIS) for mapping of traffic injuries. However, GIS may also be feasible for mapping of injuries from violence.

Aim

The aim of this study was to evaluate the feasibility of GIS for mapping injuries from violence for routine use in the ED's.

Material and Methods

The study included 1188 inhabitants of the Odense Municipality in Denmark who consecutively contacted the ED at Odense University Hospital after being victims of interpersonal violence. The degree of precision regarding location of the violent act was compared to variables related to victim and the episode. Every episode of violence was geomapped and “black-spots” was indentified.

Results

Overall 92% of the violent episodes could be mapped, 59.9% (95% CI 57.1 to 62.7) exactly, 19.0% (95% CI 16.9 to 21.4) on route, and 13.1% (95% CI 11.3 to 15.2) in known area. In children only 28.6% were mapped exactly. Violence against women was mapped exactly more common than violence against men (69.9% vs 55.6%). Domestic violence was mapped exactly in 82.8% of the episodes compared to only 56.2% of the community violence. Using the GIS it was possible to identify “black-spots”.

Conclusion

GIS seems feasible for routine mapping of episodes of violent victimisation in ED's. Most episodes are possible to map exactly, but some variation was found with gender, age and violence typology. GIS is a useful tool to illustrate the geography of violence.
Different outcomes for similar mechanisms of injury: a comparison between two groups of intentional injuries
Authors: Avitzour M , Cohen R , Peleg K
Published: March 2011

Firearms, cuts and falls from heights are the major causes of injury among hospitalised of aggressive attempted suicide (AAS) and victims of violence (VV).

Aim

To compare the outcomes of similar mechanisms of injury for patients of AAS and VV.

Method

A retrospective study using data from the Israel National Trauma Registry including 10 hospitals during the years 2003–2007. ICD9 definitions of AAS and VV were utilised.

Results

During the study period, 825 AAS patients and 7912 VV patients were hospitalised. The most common mechanism of injury for VV was stab wounds (40%) and non-firearm fighting (28%). The outcome was different, among AAS, 45% jumped from height and 32% from stab wounds. For both groups, approximately 10% were injured from firearms. AAS patients were more severe, 39% had an ISS of 16+, 45% were hospitalised for 7+ days and 31% were admitted to the ICU, compared to 16%, 16% and 9% respectively among VV. In general, VV were younger than AAS. In-hospital mortality was 8.1 times greater among AAS victims, and similarly, rehabilitation referrals were 10 times greater among AAS patients.

Conclusions and Recommendations

(1) Hospitalised AAS patients are severely injured, and require increased use of hospital resources. Further research should check if this group receives the necessary support during hospitalisation and follow up treatment after discharge. (2) Methods for reducing use of aggressive mechanisms of violence should begin with the local municipality taking responsibility and working together with other forces.
Injury mortality surveillance in Vietnam: results and recommendations
Authors: Nguyen T L H , Ngoc L T T
Published: March 2011

Background

In Vietnam, the rate of deaths due to injury was three times as high as that of deaths due to infectious diseases and injury is the leading cause of death in children under 18. Injury surveillance system was set up in 2005.

Objectives

To assess injury mortality and quality of injury mortality data recording.

Design and Subjects

We studied injury death statistic of about 90% of total 10 000 communes in 2005–2008 and conducted indept-interview with 42 health staff and 70 family members of death cases due to injuries.

Results

Injury mortality decreased from 45.01/100 000 (year-1) in 2005 to 4384/100 000 (year-1) in 2008. The 20–59 group had the highest proportion of injury mortality, followed by group of over 60. Road traffic injuries were the leading cause of death among those 15 aged and over. Drowning accounted for the highest injury mortality among those under 15. Poisoning was more common in the 20 and more age group. Falling accounted for the highest proportion of injury mortality in the 60 and more age group. Proportion of village health workers trained on recording injury mortality was low. Causes of death had not been identified and classified correctly in many communes.

Conclusions and Recommendations

This study provides use baseline information on injury mortality. The results reveal that death due to injury caused mainly by road traffic injuries and drowning and the quality of injury mortality data recording was poor and needs to be improved.
Injury prevention – a strategic priority for environmental health?
Authors: Stone D H , Morris G
Published: March 2011

Injury results from the acute transfer of energy from the environment to human tissue. It is thus, ipso facto, an environmental health issue par excellence. In this paper, we argue that injury consequently deserves consideration as a major strategic priority by environmental health professionals. Two international agreements concerning children's health and the environment have major implications for safety. The Children's Environmental Health Action Plan for Europe (CEHAPE) and the European Environmental Health Strategy (SCALE) refer to the need for improved evidence and greater co-operation between the environmental and health sectors. CEHAPE is particularly relevant to safety as it focuses on four regional priority goals, the second of which refers to the prevention and reduction of health consequences from injuries by promoting safe, secure and supportive human settlements for all children. The natural strategic home for injury prevention may therefore lie within environmental health, a domain from which it has generally been excluded. In support of this assertion, we cite Scotland's recent policy initiative on environment and human health Good Places, Better Health where injury in children up to 8 years of age is one of four child health priorities being tackled during its initial implementation. An important test of the initiative may be its capacity to inform policy, practice and research in the field of injury prevention and safety promotion. If successful, it will help to validate the environmental health approach to a field that remains relatively neglected by public agencies, policy makers, practitioners and researchers.
The attitudes of Croatian primary healthcare workers towards injury prevention/Safety promotion for preschool children
Authors: Crnica V , Miskulin M , Srcek I , Mujkic A
Published: March 2011

Objective

In the period from 1995 to 2008, in Croatia, 2.553 children died because of injuries, making injury prevention efforts an important societal investment. The aim of this study was to establish the attitudes of primary healthcare workers in a sample comprised of gynaecologists and paediatricians working in the primary healthcare, family physicians and community nurses.

Participants

373 primary healthcare workers (gynaecologists, paediatricians, family physicians and community nurses).

Methods

Anonymous self-administered questionnaire containing items on gender, age, length and type of work and the Croatian primary healthcare workers attitudes towards injury prevention/safety promotion for preschool children.

Outcome Measures

Attitudes towards injury prevention/safety promotion for pre-school children.

Results

The obtained results varied greatly for different questions. For example, almost all primary healthcare workers showed correct attitudes towards prevention of drowning during bathing, prevention of playground injuries and the prevention of traffic injuries by forbidding preschool children sitting in the front seat (366 or 98.1%) and forbidding standing between the front seats during the ride (367 or 98.4%). But only 46.4% subjects recognise provocation of vomiting after a child has swallowed a potential poison as an incorrect response.

Conclusions

Although a majority of primary healthcare workers demonstrated satisfactory attitudes, improvements are possible and necessary. A targeted, continuous education on the subject must be considered as one of the primary healthcare measures in the Croatian national program of healthcare measures.
Safe At Home – the National Home Safety Equipment Scheme
Authors: Merril S , Taylor E
Published: March 2011

Safe At Home (National Home Safety Equipment Scheme) is an 18 million initiative supported by the Department for Children Schools and Families. Its aim is to help families keep their children safe and to reduce accident rates in the home. Working with locally based delivery partners the scheme is providing home safety equipment to over 100 000 of the most disadvantaged families in areas with the highest accident rates. The equipment which is provided with a fitting service includes safety gates, fireguards, window restrictors, cupboard locks, corner cushions and bathmats. The scheme is not just about equipment. Over 2 years it will provide 500 000 families with information and support that will help them to create a safer environment. Safe At Home is also rolling out a comprehensive training programme for delivery partners who work with families, with over 3000 training places being offered throughout the scheme. A website a vital resource for both families and local schemes was launched in June. Seehttp://www.safeathome.rospa.com/. Other developments include a DVD with training notes and discussion points which is used as part of a facilitated session. An accompanying height chart, highlighting the key risks and prevention advice left with each family is a practical aid that backs up the information in the DVD. Working within 140 Local Authorities the scheme is an excellent example of multi-agency working. Independent evaluation will identify effectiveness and appropriateness. We will also be able to share the challenges and solutions in delivering such an extensive project.
Line of duty deaths among U.S. firefighters: an analysis of fatality investigations
Authors: DeJoy D M , Kunadharaju K , Smith T D
Published: March 2011

Firefighting is a high hazard occupation. In the U.S. alone, over 100 firefighters die in the line-of-duty each year and over 80 000 are injured. In this presentation, we summarise results from an independent analysis of firefighter fatality investigations completed by the National Institute for Occupational Safety and Health (NIOSH) between 2004 and 2008 (N=143). Of the 143 investigation reports reviewed, 80 involved medically related fatalities and 63 involved fatal traumatic injuries. The 143 investigations produced a total of 867 recommendations for improvements or corrective actions: 417 from medical investigations and 450 from trauma investigations. Using spreadsheet and relational data base software, we identified 35 high frequency recommendations. These high frequency recommendations were mapped onto the major components of firefighting operations (personnel, incident command, operations/tactics and equipment) using a fishbone or Ishikawa diagram. The personnel component of the fishbone diagram accounted for 14 high frequency recommendations and three contributing factors: readiness, training and staffing. A total of nine recommendations were classified within the incident command component and arrayed in terms of four contributors: risk assessment, accountability/rescue, role maintenance and standard operating procedures (SOPs). These results point to deficiencies in personnel management and operational supervision, and suggest that many firefighting organisations routinely accept very thin margins of operational safety. The NIOSH investigative protocol, while quite thorough, provides only very limited insight into the organisational and/or cultural forces that give rise to such acceptance. Recommendations for addressing this situation are discussed.
Amending the public policy model underlying the public health approach to injury prevention in order to improve the translation of research-to-practice
Authors: Bugeja L , McClure R
Published: March 2011

Background

Despite widespread application of the public health approach to injury prevention there is an acknowledged limitation in the extent to which it facilitates translation of research evidence to injury prevention practice.

Aims

This paper critically examines the contemporary public health approach using the academic framework of public policy with view to amending the approach to improve the translation of research to practice.

Methods

A fatal injury case study drawn the Australian experience is used to illustrate the limitations of public policy model underlying the contemporary public health approach to injury prevention and the better performance of a preferred public policy model in terms of the extent to which each facilitates translation of research to practice.

Results

In this case study, careful accumulation of evidence relating to policy definition, causation and intervention efficacy within the research domain did not lead to policy action once this evidence was placed on the public agenda. Policy action was only achieved as a result of a window of opportunity that arose when the spate of drowning in 2004, generated public recognition of the problem and generated political will to recognise and hence implement existing policy solutions.

Discussion and Conclusions

The rational model that underlies the contemporary approach to injury prevention is consistent with the stages of empirical scientific method but not consistent with the mechanisms that drive policy implementation. The implications for these findings for the public health approach to injury prevention are that it needs to be adapted so that its foundation model from the rational to the incremental approach.
Driving errors influence an older drivers decision to give up or restrict driving
Authors: Keay L , Munoz B , Turano K , Munro C , Duncan D D , Baldwin K , Bandeen-Roche K J , Gower E W , West S K
Published: March 2011

Purpose

Explore driving errors in older drivers and the subsequent decision to restrict or stop driving.

Methods

1425 drivers aged 67–87, enrolled in a longitudinal study completed 5-day naturalistic driving assessment. Rate of failure to stop at red traffic lights, stop signs or safely execute left turns were modelled as predictors of stopping or restricting driving.

Results

1237 (87%) completed 12-months, excluding those already restricting driving(n=35), 1.5% (18/1202) had stopped and 3.4% (41/1202) restricted their driving. Errors were observed in 32/1171 (2.7%) participants at red lights, 75/1155 (6.5%) at stop-signs, 88/1170 (7.5%) at left turns. The average failure rate per traffic light, stop sign and left turn was 0.2%, 2.2% and 0.4%, respectively. Police stopped 182 drivers during the year (15%), 81 were issued infringement notices (7%) and 34 were advised to stop or restrict driving (3%) however these factors were not predictive of incident driving change. Those with traffic light failures were more likely to stop or restrict their driving (adjusted OR 1.295; 95% CI 1.078 to 1.555 per per cent increase in failure rate). Failed stop sign (p=0.6) and left turns (p=0.4) were not predictive.

Conclusions

Driving errors were measured objectively in a large cohort of older drivers. While a rare event, red traffic light errors increased likelihood of subsequently restricting or ceasing driving. These findings lend support for self-regulation of driving exposure.
4 Fires, 63 Years and 952 deaths – what have we learned?
Authors: Williams D A , Williams J P
Published: March 2011

Nightclubs are a place for fun and merriment for patrons, but in some cases they become death traps for those who are unfortunate enough to be caught in a fire. In this presentation, we will look at four fires that occurred in the United States that claimed 952 lives and what common themes were presented that connect these fires that span 63 years. A search of the Duquesne University library with Google Scholar search of nightclub fire produced multiple results from which a convenience sample was extracted according to relevance as determined by the authors. Four incidents that accounted for the worst loss of life in nightclub fires in the United States were selected: The Rhythm Club in Natchez, Mississippi in 1940, The Coconut Grove in Boston, Massachusetts in 1942, The Beverly Hills Supper Club in Southgate, Kentucky in 1977 and The Station in East Warwick, Rhode Island in 2003. In each of these cases the following difficulties were noted: action or inaction by the appropriate governmental agencies during construction, and subsequent inspections; actions by the owners including faulty construction; blocked doors resulting in impeded egress from the facilities and flammability of interior furnishings including decorations, pyrotechnic displays and other materials all contributed to the loss of life. We will investigate the source of these tragedies and changes that were made to help to prevent this type of conflagration in the future.
Quality of child abuse information for measurement and surveillance: linking hospital and child welfare data
Authors: McKenzie K , Scott D , Fraser J , Dunne M
Published: March 2011

National estimates of the prevalence of child abuse-related injuries are obtained from a variety of sectors including welfare, justice and health resulting in inconsistent estimates across sectors. The International Classification of Diseases (ICD) is used as the international standard for categorising health data and aggregating data for statistical purposes, though there has been limited validation of the quality, completeness or concordance of these data with other sectors. This research study examined the quality of documentation and coding of child abuse recorded in hospital records in Queensland and the concordance of these data with child welfare records. A retrospective medical record review was used to examine the clinical documentation of over 1000 hospitalised injured children from 20 hospitals in Queensland. A data linkage methodology was used to link these records with records in the child welfare database. Cases were sampled from three sub-groups according to the presence of target ICD codes: Definite abuse, Possible abuse, unintentional injury. Less than 2% of cases coded as being unintentional were recoded after review as being possible abuse, and only 5% of cases coded as possible abuse cases were reclassified as unintentional, though there was greater variation in the classification of cases as definite abuse compared to possible abuse. Concordance of health data with child welfare data varied across patient subgroups. This study will inform the development of strategies to improve the quality, consistency and concordance of information between health and welfare agencies to ensure adequate system responses to children at risk of abuse.