bluuebunny/crossref_metadata_2025 huggingface dataset:
Human error assessment and management in Isfahan oil refinery work station operators by Sherpa technique
Authors: Habibi E , Garbe G , Reasmanjeyan M , Hasanzadah E
Published: October 2012

Introduction

In many work environments with sensitive and complex technologies, human error due to the unfortunate events is very important. So it is necessary to recognise and find root causes of human errors to prevent and limit the consequences of them. This study aimed to identify operator's human error in one of the sensitive units of oil refinery.

Methods

This study was taken to identify, assess and control human errors in Tar unit of Isfahan oil refinery. Data collected using by task observation and interviewing with safety authorities, unit and shift supervisors and operators to hierarchical task analysis (HTA) and human error identification by SHERPA technique.

Results

With analyses SHERPA work sheets, 198 human errors were identified respectively 134(67.64%) action errors, 23(11.61%) checking errors, 11(5.6%) communication errors, 24 (12.12%) retrieval error and 6(3.03) selection errors. ‘Performance monitoring’ and ‘communication’ Critical tasks was the main tasks of control room operators. 64% of human error in the control room operators of the occurrence probability of ‘low’ and 36% probability of occurrence of ‘moderate’ were estimated. Also, 59% of the identified errors of control room operators have no required recovery but only 29% of their outcomes were sensitive.

Conclusions

The results showed SHERPA technique can be used serve as an effective technique to detect human errors in oil refineries and petrochemical.
Economic burden of various injuries in a low income community
Authors: Ibraheem GH , Ofoegbu CKP , Nasir AA , Solagberu BA
Published: October 2012

Background

Injuries pose an economic problem of immense proportion to communities in every society. Studies aimed at estimating financial losses that are incurred as a result of traumatic injuries by the patient and caregivers are very limited especially in this environment. The economic burden from injuries can be quantified through cost-of-injury studies, using techniques adopted from cost-of-illness research.

Aims/Objectives/Purpose

To ascertain the direct costs of traumatic injuries and their determinants.

Methods

Patients who presented to the accident and emergency unit of the University of Ilorin Teaching Hospital in Ilorin following traumatic injury were recruited. The incurred direct costs estimated were calculated for each patient until discharge. These include the hospital admission bills, costs of drugs used, costs of procedures, investigations, etc.

Results/Outcome

72% of the 168 patients recruited were male and majority of them were young adults. Mean direct cost per injury was N 4061 ($27.1) with cost of drugs and procedures accounting for 37.2% and 27.4% of the total costs respectively.

Significance/Contribution to the Field

The calculated direct costs of injury from this study represent a significant economic drain in this environment where 64% of the population lives on less than $1.25 per day. Extrapolating even these limited cost estimates of direct medical treatment to the fatal as well as the even larger non-fatal injury burden in Nigeria, exposes the immense financial drain to the individual patient, their caregivers as well as the larger community.
Establishing a Trauma registry in a level 1 Trauma centre in Subsaharan Africa—challenges and local experience
Authors: Adeleke O Ifesanya , Oludolapo O Afuwape , Ambrose Rukewe , Temitope O Alonge
Published: October 2012

Background

In developing countries, the accurate burden of trauma usually cannot be quantified. Our hospital, the largest in the country does not have a trauma registry.

Objectives

We share experiences in establishing a trauma registry in our hospital, reviewing the first 103 cases and identifying the challenges.

Methods

A trauma study group consisting of emergency physicians and three trauma surgeons drew up modalities of the project and funding was from personal contributions. A questionnaire was developed and administered to all trauma patients presenting to the emergency room and updated until discharge. Monthly meetings were held by the group to review progress.

Results

Mean age was 34.2±18.2 years with a male: female ratio of 3.1. Most injuries occurred between 13 : 00–18 : 59 h. Average revised trauma score was 11.5±1.1 (range=7–12). Delay before reaching the first hospital was 16.2 h and 24.9 h before arrival at our A&E. Blunt injuries caused 72% and penetrating injuries 14%. About half were traffic crash victims, 12% falls, 7% gunshot and burns 6%. About 62% of injuries ocurred on roads. Passers-by provided first aid in 12%, 47% received none. Only one patient received on-scene cardiopulmonary resuscitation. Orthopaedics (41%), Neurosurgery (22%), and Plastic, reconstructive and burns (18%) teams were the most called. Our challenges included duplicate or incomplete documentation, missed cases, cost of registry software, payment of staff, unretrieved questionnaires and cumbersome data spreadsheet.

Significance

The study shows that personal effort could be successful at developing a trauma registry. The use of expensive software is not always necessary.
Inadequacy of facial injury surveillance in Sri Lanka: a qualitative study of barriers in the routine health information system
Authors: Abeysekara WPMM
Published: October 2012

Background

Injury surveillance in the health care system in Sri Lanka currently operates through Indoor Morbidity Mortality returns prepared according to the International Classification of Diseases codes from curative centres. Facial injuries are exclusively managed at Oral and Maxillofacial units. An initial survey revealed that facial injury information received by the health information unit is inadequate.

Objective

To describe the barriers in the facial injury surveillance system.

Methods

Twelve in-depth interviews were carried out with seven categories of health staff involved in all the levels of information chain.

Results

The administrative process involved in facial injury management is complicated. This directly affects the information flow. Staff is overburdened with clinical work. Negative attitude of the clinical staff towards injury surveillance is a major barrier. Too much paperwork involved in information process reduces the efficiency. Surveillance system is not properly regulated. Inadequacy of knowledge on information of the curative staff categories leads to inaccuracy in compiling data.

Significance to the Field

This study underlines the need of a user friendly and efficient method of facial injury data collection with proper regulatory mechanism and improvement of knowledge of the staff categories involved in information chain for the improvement of facial injury surveillance in Sri Lanka.
Evaluation of enforcement programme to increase seatbelt use: a case study in precinct 8, Putrajaya
Authors: Ghani Y , Isah N , Saleh S , Soid N F Mohd
Published: October 2012

Background

Road safety issue is a major problem in Malaysia, with close to 7000 deaths are recorded every year. The government has introduced a number of intervention programmes nationwide to reduce fatalities. At the nation's administrative capital Putrajaya, in particular, the government in 2011 has embarked on a ‘safe city’ programme, emphasising on road safety issues through a community-based programme. The Precinct 8 was chosen for the intervention programmes that emphasis on enforcement, education, and campaign for a 6-month period.

Objectives

It aimed to evaluate the percentage of seatbelt use among the community before, during, and after the intervention period.

Methods

To measure the effectiveness of the programme, a scientific research via observation was carried out.

Results

A total of 9487 all type of car occupants in Precinct 8, Putrajaya were observed. The study revealed that seatbelt use increased from 42% to 58%, before and during the enforcement period, respectively. The post enforcement period, however, revealed that the percentage of seatbelt compliance has decreased to 55%. A χ2test for independence indicated a significant association between enforcement programme period and seatbelt use, χ2(2, 9487)=202.36, p=0.0001. Car occupants were one time more likely to use seatbelts during enforcement programme as compared to before enforcement programme was implemented (with RR: 1.371, 95% CI 1.31 to 1.44).

Significance to the Field

The study concluded that the dosage of enforcement directly contributed to the seatbelt compliance. The study can be replicated in terms of programme design and implementation in other communities.
Independent risk factors for injury in pre-school children: three population-based nested case-control studies using routine primary care data
Authors: Kendrick D , Orton E , West J , Tata L
Published: October 2012

Background

Injuries in childhood are largely preventable but continue to be a public health problem. However, the factors that contribute to injury occurrence have not been quantified at the population scale using primary care data.

Aims/Objectives/Purpose

We used The Health Improvement Network database from the UK to identify risk factors for thermal injury, fractures and poisoning in pre-school children in order to inform the optimal delivery of preventative strategies.

Methods

We used a matched, nested case-control study design. Cases were children under 5 with a first medically-recorded injury, comprising 3649 thermal injury, 4050 fracture and 2193 poisoning cases, matched on general practice to 94 620 control children.

Results/Outcome

Younger maternal age and higher birth order increased the odds of all injuries. Children's age of highest injury risk varied by injury type; compared with children under 1, thermal injuries were highest in those age 1–2 (OR=2.43, 95% CI 2.23 to 2.65), poisonings in those age 2–3 (OR=7.32, 95% CI 6.26 to 8.58) and fractures in those age 3–5 (OR=3.80, 95% CI 3.42 to 4.23).

Increasing deprivation was an important risk factor for poisonings and thermal injuries as was alcohol misuse by a household adult (OR=1.73, 95% CI 1.26 to 2.38 and OR=1.39, 95% CI 1.07 to 1.81 respectively) and maternal diagnosis of depression (OR=1.45, 95% CI 1.24 to 1.70 and OR=1.16, 95% CI 1.02 to 1.32 respectively).

Significance/Contribution to the Field

Maternal depression, adult alcohol misuse and deprivation represent important modifiable risk factors for thermal injury and poisoning but not fractures in preschool children. Since these risk factors can be ascertained using routine primary care records, at risk children can be identified and offered preventative interventions.
Study on occupational injuries related death through the mortality reporting system from 2005–2010 in Vietnam
Authors: Pham LT , Khieu TQT , Luong MA , Tran TNL
Published: October 2012

Background

Occupational injury (OI) is one of the five leading causes of death related injury in Viet Nam. In order to assess the situation of OI in Vietnam from 2005–2010, the study examined all causes specific mortality of over 10 000 communes.

Objective and Method

Retrospective method.

Results

There were 1883 deaths related OI which were accounted for 5.32% of total injuries during 2005–2010. In comparison with 2005, the mortality ratio in 2010 was slightly higher (with 2.64/100 000 population in 2010 and 2.3/100 000 in 2005). OI occupied the forth position among the leading causes of death related injury, only after road traffic injuries, drowning and suicide. Deaths related OI were 1.5; 1.8 and 2.2 times higher than that of falls, poisoning, and burns and violence, respectively. More than 80% deaths related OI occurred in male. Age group 20–59 had the highest number of deaths related OI. This could be explained that people at the age group 20–59 are the major workforce in Viet Nam.

Significance

Development of policy to reduce OI deaths requires appropriate interventional measures such as national plans on occupational health and safety, enhancement of pre-hospital trauma care at workplace and health promotion at work, improvement of working conditions and implementation of sentinel surveillance systems on OI at some key industrial zones.
The under-report adjustment of injury deaths data from National disease surveillance points system of China
Authors: Li Q , Zhou M , Bishai D , Wang L , Ma S , Hyder AA
Published: October 2012

Background

The National Disease Surveillance Points System (DSPs) of China was established in 1980, and currently consists of 161 nationally representative urban and rural sites from 31 provinces covering 78 million people, a roughly 6% of Chinese population. To estimate the completeness of DSPs data, an independent household investigation of missing were conducted in 2009.

Aims/Objectives/Purpose

To adjust the underreporting of injury death data in DSPs system.

Methods

This paper proposes and compares two methods to correct for underreporting of injury deaths. First a cell-based weighting system is applied whereby underreporting rates for 18 cells defined by 3 age groups×2 sexes×3 regions were computed using the household survey as a gold standard. The second method is a propensity weighting method based on a logistic regression of underreport against age, sex, region, season, education, occupation, place of death and cause of death.

Results/Outcome

The results from both adjustment methods performed better than the original DSPs data, compared with estimates from other sources such as WHO. The Life Expectancy at age 5 is 72.1 years in unadjusted data while compartment method and propensity weighting method respectively give 70.0 and 69.8, much closer to WHO estimate 70.3.

Significance/Contribution to the Field

The adjusted DSPs data could provide valuable information for evidence-based injury-related policy-making in China. Additionally, the two approaches compared here can be applicable for other developing countries that also suffer underreporting problems.
Using National Health Insurance claims data to establish injury surveillance in Taiwan: a feasibility study
Authors: Tsung-Hsueh LU
Published: October 2012

Background

The National Health Insurance (NHI) programme was launched in 1995 in Taiwan and nearly 99% of 23 million citizens are enrolled in the NHI in 2010.

Objective

To examine the feasibility of using NHI discharge claims data to establish injury surveillance system in Taiwan.

Methods

There are three diagnoses variables for emergency room visits (ERV) in outpatient claims data and five diagnoses variables and two variables for external causes of injury codes (E-codes) in inpatient hospitalisation (IH) claims data. We used claims data of year 2008 to examine the completeness and specificity of reporting E-codes in claims data. The injured cases were defined as having ICD-9-CM nature of injury codes (N-codes) 800–999 in any one of the diagnosis variables.

Results

A total of 16 164 861 cases (350 835 ERV and 265 651 IH) with injury N-codes were identified in NHI claims data in 2008 which resulted in an overall incidence rate of 7093 per 100 000 population. Unfortunately, only 3% of ERV and 75% of IH with N-codes had E-codes reported. Of 154 hospitals with N-code as the main diagnosis in IH in 2008, only 27 hospitals had percentage of non-reporting of E-code higher than 80%.

Significance

Efforts are needed to improve the percentage of reporting E-code among ERV and IH with injury to promote the feasibility of using NHI claims data as injury surveillance system in Taiwan.
Acute neck injuries in Ilorin
Authors: Ofoegbu CKP , Afolabi OA , Nasir AA , Abdur-Rahman LO , Solagberu BA
Published: October 2012

Background

Neck injuries are common problems among trauma victims. There is paucity of data on neck injury in Nigeria.

Objective

To present the characteristics of neck injuries in Ilorin.

Methods

A prospective study of all patients with neck injury seen at the accident and emergency department of University of Ilorin Teaching Hospital, north-central Nigeria. Questionnaires were used to retrieve information on demographic data and clinical details of patients. All information was entered into an SPSS computer soft ware V.17.0 and result analysed descriptively.

Results

A total of 22 patients were recruited for the study age range 22–70 years, median age 31.0 years. There were 16 males and 6 females with M : F ratio of 2.7 : 1. The marital status indicated that 17(77.3%) were married and 5(22.7%) were single. The modal age were those in the 2nd and 3rd decade of life (40.9% each). The commonest source of neck injury was road traffic injury in 90.9%. Blunt injury to the neck was the commonest injury encountered in 15 (68.2%), spinal cord was the commonest tissue affected in 15 (68.2%) and majority of the patient presented within 1–6 h (50%) of injury time, Zone II of the neck was commonly affected in 90.9%. about 50% of the patients had non-surgical treatment.

Significant/Contribution to the Field

Acute neck injury is still a challenge among the road traffic injured patients in Nigeria with economically productive male being mostly affected.
The prevalence of motorcycle helmet use in three Mexican cities
Authors: Chandran A , Lunnen JC , Pérez-Núñez R , Híjar MM , Hidalgo-Solórzano E , Hyder AA
Published: October 2012

Background

Appropriate motorcycle helmet use can reduce the risk of death by 40% and severe injury by 70% in the event of a crash. Motorcycle use has increased in Mexico in recent years, less is known about the prevalence of helmet use—an important first step in advocating for change.

Aims/Objectives/Purpose

To quantify the prevalence of motorcycle helmet use in three Mexican cities (Guadalajara-Zapopan, León, and Cuernavaca) within the context of ongoing road safety initiatives.

Methods

Serial roadside observations were conducted by investigators from the Instituto Nacional de Salud Pública in Mexico and the Johns Hopkins International Injury Research Unit in November 2010, and June, and December 2011. Observations were done at randomly selected intersections with functioning traffic lights across varied days, times, and direction of travel.

Results/Outcomes

A total of 6990 motorcycle users were observed: 94% were males, 89% were aged 18 years or older, and 90% were motorcycle drivers. Helmet use was higher among drivers than passengers (78.4% vs 55.2%, p<0.01) and among males than females (77.1% vs 59.4%, p<0.01). The overall prevalence of proper motorcycle helmet use was 76.1%; use was highest (p<0.01) in León (90.3%), followed by Cuernavaca (75.8%). Overall, helmet use among children <10 years was 48.3%, compared to ∼75% in older individuals.

Significance/Contribution to the Field

Roadside observations indicate motorcycle helmet use in three Mexican cities needs to be improved. Since motorcycle use is increasing in Mexico, targeted interventions are necessary to impact this preventable cause of death and injury.
Investigating the effects of installing safety cameras on managing the incidents and the risk assessments in SAIPA (an Asian Automotive Corporation)
Authors: Mahyar B , Abdi J , Minoo A
Published: October 2012

Objectives

In this research the effects of installing safety cameras on reducing the severity or frequency of incidents and resolving the OHSAS non-conformities were investigated.

Background

The research was carried out in SAIPA Automotive Corporation, in which the number of employees exceeds 10 000 people. In this company, the safety supervising is being done by the safety experts during the daily site visits, however, some negligible yet important issues may be neglected in the risk assessments. Also, the details of some incidents can be disregarded specially when there is a lack of eyewitness. By inspecting the CCTV (Closed-Circuit Television) clip of an incident, its exact cause can be determined which may avoid reoccurrence of the incident and reduce the risk level in the future. Ignoring the perfect management of the conditions, may result in lethal accidents.

Significance

The monitoring systems in the workshops simplified finding out the causes of some unsafe conditions. Therefore, Fault Tree Analysis, Event Tree Analysis and Failure Mode and Effects Analysis methods can be implemented better than before.

Methods

The approach was the case study of the subject by registering the recorded data for 3 months and analysing the data to extract the difference before and after applying the cameras for safety inspection.

Outcome

It was shown that using the safety cameras and watching the clips of incidents carefully, plays a major role in reducing such incidents, increasing the safety level of workshops, and improving the accuracy and repeatability of risk assessments.
Differences in risk-adjusted outcome of road traffic injuries in urban tertiary care Centres of Pakistan: analysis of surveillance data
Authors: Mehmood A , Razzak J , Mir U , Jooma R
Published: October 2012

Background

Trauma due to road traffic injuries (RTIs) poses a considerable burden on the healthcare system. Outcome of trauma varies between countries, within countries and between different trauma centres. This variation reflects the potential for improvement in trauma care.

Aims and Objectives

To assess the difference in RTI trauma survival among five tertiary care institutes in Karachi, Pakistan.

Methods

All cases registered in the RTI surveillance system (operational in five major tertiary care hospitals in Karachi) between September 2006 and September 2009 were included. Data on the patients' age, sex, mode and delay in arrival, type and severity of injury were extracted. Data were stratified by hospital of presentation and distribution of these factors was assessed between the five groups. Logistic regression was used to assess the association between patient characteristics and in-hospital survival after an RTI.

Results

A total of 94 316 patients were included in this study. Only 11% were women and 74% of the sample was between 15–45 years of age. Most of the injuries (96%) had an ISS between 1 and 15 and in-hospital survival was 97.4%. Survival was strongly associated with hospital of presentation (AOR 4.4, CI 3.4 to 5.7). Other significant predictors of survival included mode of arrival (AOR 1.5, CI 1.2 to 1.8) and age (AOR 0.16, CI 0.09 to 0.26) after adjustment for severity and type of injury.

Significance

The analysis shows a strong association between centre and survival even after adjustment for type and severity of injury and other important confounders. This indicates differences in quality of trauma care within hospitals in Karachi requiring further in-depth studies for healthcare policy change.
The impact of socio economic factors on injuries in Tehran, IR Iran
Authors: Moghisi AR , Farshad A
Published: October 2012

Introduction

Tehran is the capital city of IR Iran with about 12 000 000 inhabitants. Consisting of 22 districts. Injuries happen with different rate and type in different zones.

Objectives

To improve urban management in terms of injury prevention.

Methodology

10% of population on of Tehran was considered for the households' survey. A questioner based on Urban HEART (urban Health Equity Assessment and Response Tool) was prepared and validated. Interviewers were trained uniformly. SPSS soft ware was used to analysing data.

Result

Females were mostly involved in fall, burn and poisoning while men were mostly involved in traffic related accidents, interpersonal violence and electric shocks. Most accidents were among families with 3–5 members. Young's adult aging 15–40-years-old and living in the low income districts of Tehran were the most affected by accidents? Young males who are the residence of districts 14, 15, 18, 9, 19 and 4 are the most affecting victims by traffic related accidents. In district 11, 12, 14 most of the victims were motorcyclists. In districts 2, 3 and 5 victims were shifted towards pedestrians predominantly. Children and old ages are mostly the victims of fall related accidents; there was no gender differences detected in most of the districts area except in district 19 where males were falling twice than females, in districts 1, 2, 3 and 12 this ratio was vice versa (p<0.05). Burns related accidents were recorded more in districts 13, 16, 17, 12 and the least from districts 3, 2, and 5 respectively(p<0.05, 95% CI).

Significance to the Field

The result of this study will be used as a baseline data for interventions assessment in future.
Accidental casualties and deaths in India due to un-natural causes, 2009–2010
Authors: Bikash Mohapatra , Nath Samantray Surendra
Published: October 2012

In India, a total of 678 326 cases of ‘Un-Natural Accidents’ caused 359 583 deaths and rendered 503 932 people injured during 2010. The age-group-wise distribution of Accidental Deaths by various Un-Natural Causes along with their share in total deaths is presented in this secondary study. The ‘Accidental Deaths’ due to Un- Natural Causes were mainly on account of ‘Road Accidents’ (37.2%), Railway Accidents and Rail-Road accidents (7.7%), ‘Poisoning’ (7.8%), ‘Drowning’ (7.8%), ‘Sudden Deaths’ (7.6%) and ‘Fire Accidents’ (6.8%). The number of cases of Un-natural accidents at the National level has increased by 4.7% (from 647 904 in 2009 to 678 326 in 2010) as compared to previous year. The number of persons injured has increased by 1.6% (from 496 190 in 2009 to 503 932 in 2010) while the number of persons killed in these accidents has increased by 7.4% (from 334 766 in 2009 to 359 583 in 2010). The Accident cases due to ‘Stampede’ have decreased by 93.0% (from 1532 in 2009 to 107 in 2010) and cases of ‘Killed by animals’ have decreased by 13.3% from 1293 in 2009 to 1121 in 2010 while cases due to ‘Air crash’ increased by 75.0% from 8 in 2009 to 14 in 2010. The proportion of male injured and killed due to un-natural causes in the country was 80.5% and 77.6% respectively of the total such injuries and deaths. 93.4% of injuries and 37.2% of deaths were due to Road Accidents only at the National level. Males out-numbered females in all kinds of accidental casualties except ‘Fire Accidents’ where 66.6% of those killed were females as compared to 33.4% males. The study revealed that accidents due to ‘Un-Natural Causes’ are preventable in nature and can be reduced by adopting adequate safety measures.
Injury surveillance at BIR hospital, Kathmandu, Nepal—initial 1 year report
Authors: Bajracharya AR , Thapa B
Published: October 2012

Background

Although injury is being realised increasing every year and becoming almost 4th cause of death and disability in Nepal, no formal study producing data has yet ever been carried out. So a beginning was made for the first time at this central government hospital of Nepal an Injury surveillance was started. A year's data was obtained. Ultimately we hope to have country wide Injury surveillance system in Nepal.

Purpose

To project one complete year hospital data on injury.

Methods

Injury surveillance data collection form was developed. Forms were filled up by trained medical personals at casualty and Out patients departments. Data from 16 July 2010 to 17 July 2011 were compiled, analysed and presented.

Results/Outcomes

Total number of injuries attended were 6093, 71% Male, 29% female,. Among 6903 people 1903 people got injured in Road traffic accidents. Among them approximately half of the people got injured while they were travelling in Motorcycle/Scooter in the road (48.32%). 36.62% of the people got injured while they were walking on the road. 8.46% of the people were travelling in truck/bus. 67.32% were non-medico-legal cases, Injury on road was (42.47%). at home (32.75%), at workplace 11.37%, at school 5.11% at playground. 4.05% and at farm 49%.

Conclusions

An overall profile of injury cases attending this hospital over a year shows variables that can contribute significantly to make plans, policies and programmes towards Injury prevention and control programmes in Nepal.
The effectiveness of enforcement programme in promoting proper helmet wearing among motorcyclists in precinct 8, Putrajaya
Authors: Ghani Y , Soid N F Mohd , Isah N , Saleh S
Published: October 2012

Background

In 2010, there were 120 156 crashes involving motorcyclists in Malaysia. Overall, the motorcycle riders and pillions were over represented with 4036 (58.7%) deaths. The higher number of deaths often associated with head injuries due to improper helmet wearing. Even at the nation's administrative capital Putrajaya, road crashes among motorcyclists are rampant. Therefore, an initiative was taken by introducing the ‘Safe City Concept’ which emphasised on Community Based Programme (CBP) to improve the state of road safety among motorcyclists. A series of enforcement programme was initiated by the community, enforcement agencies, and local authority.

Objectives

The study was carried out to determine effectiveness of the 6-month enforcement programme by focusing on the percentage of proper helmet wearing.

Methods

A 2 h observation programme was executed weekly in Precinct 8, Putrajaya, specifically targeting at motorcyclists. The percentage of proper helmet wearing rate among motorcyclists was measured before, during, and after the enforcement programme was carried out.

Results

A total of 2949 motorcyclists were observed. The study highlighted that the proper helmet wearing in Precinct 8 was twice as higher during the enforcement programme as compared to before enforcement programme (RR=2.2.537; 95% CI 2.019 to 3.187). Female motorcyclists were 2 times more likely to wear helmet properly as compared to male (with OR=2.1243; 95% CI 1.510 to 2.989).

Significance to the Field

The study concluded that enforcement programme in Precinct 8, Putrajaya was proven effective in increasing the proper helmet wearing compliance. Findings of the study can act as guidelines for programme design and implementation.
Predictors of missing data in injury surveillance: an observational study
Authors: O'Reilly G , Cameron P , Jolley D
Published: October 2012

Background

Trauma registry data are almost always incomplete. Traditional approaches to dealing with missing data lead to biased outcomes and conclusions. Multiple imputation can reduce bias in registry analyses but the ideal approach would be to improve data capture.

Aim

The aim of the study was to identify which patients were most likely to have incomplete data.

Methods

An analysis of prospectively collected regional trauma registry data over 1 year was performed. Variables used for trauma system benchmarking were analysed. Logistic regression analyses were performed to identify predictors of missingness. These analyses were conducted following complete data estimation using multiple imputation.

Results

There were 2520 cases. The variables with the greatest proportion of missing observations were respiratory rate, GCS and systolic blood pressure. Data for these physiological variables were more likely to be missing when the patient died in hospital. GCS and respiratory rate were more likely to be missing when they were abnormal. A major predictor of a missing GCS or respiratory rate was an abnormal pre-hospital GCS; an additional predictor of a missing blood pressure was whether the patient was transferred to a second hospital for definitive care.

Significance

Death in hospital was a predictor of missingness for all of the primary hospital physiological variables. An abnormal GCS and respiratory rate were more likely to be missing from the dataset. In addition to reducing bias during data analysis, multiple imputation can be used to inform improvements in data capture.
Progress in preventing injuries: a content analysis of national policies in Europe
Authors: Nikesh Parekh , Francesco Mitis , Dinesh Sethi
Published: October 2012

Background

Injury prevention has featured as a relatively low priority on Government health agendas in Europe and elsewhere, the result of which has been a lack of national policy development. Successful policy making criteria have not been used to systematically evaluate injury and violence prevention policies.

Aim

To provide a content analysis of national policies to address violence and injury prevention in the WHO European Region so as to inform where improvements can be made in developing policy.

Methods

A network of health ministry focal persons, an internet search of relevant Ministry web-sites, and a Google-search using key words were used to identify national policies for violence and injury prevention. A framework was used for policy content analysis.

Results

The majority of national policies had been developed after 2003. 80 English-language policies from 26 countries were analysed further and 43 non-English policies from 16 countries were excluded. The majority of policies fulfilled the criteria for successful health policy making: lead body, intersectoral collaboration, budgets, government approval, defined implementations, timeframe, evaluation. Some areas warranted attention such as quantitative objectives, target population and implementing interventions not based on evidence.

Conclusions

Encouraging progress is being made in the WHO European Region. Following the criteria for successful policy making more closely could increase the effectiveness of the preparation and implementation of policies for violence and injury prevention. Areas that warrant attention include setting targets for child maltreatment and domestic violence prevention, as do certain types of injury and violence prevention such as suicide prevention.
The Velestino study: are traumatic brain injuries in the life-course linked to cognitive impairment among seniors?
Authors: Michelakos T , Kousoulis A , Kanavidis P , Katsiardanis K , Stefanadis Ch , Petridou E
Published: October 2012

Background

Several publications have reported persistent changes of cognition/earlier cognitive impairment among individuals, especially athletes, with a concussion history, even following a single traumatic brain injury (TBI).

Objective

To explore the impact on late-life cognitive performance of TBI experienced during the life-course of seniors residing in Velestino, a Greek agricultural town.

Methods

In a health and safety of seniors study, 94 brain injuries, 49 of which were hospital-treated, were reported by all 593 elderly aged 65+ years. The odds of being cognitively impaired, assessed by the Mini-Mental State Examination, among those with a positive TBI history as compared to those without, was calculated after controlling for known confounding factors.

Results

The proportion of TBI (hospitalised) among cognitively impaired males was 16.9% (9.7%) and 14.7% (4.9%) among females, whereas for non-impaired males 21.1% (14.8%) and 11.2% (6.0%) among females. The ORs for being cognitively impaired after a TBI was 0.68 (95% CI 0.33 to 1.41, p=0.30) among males and 1.26 (95% CI 0.60 to 2.64, p=0.54) among females; the respective ORs after a hospitalised TBI were 0.78 (95% CI 0.33 to 1.88, p=0.58) and 0.68 (95% CI 0.23 to 1.98, p=0.48).

Significance

Our results showing lack of association between reported TBI and cognitive impairment in the cross-sectional VELESTINO study need to be compared with those deriving from our ongoing systematic review assessing the frequency and intensity of exposure that might be necessary in order to cause permanent brain lesions and consequently lead to cognitive impairment as it is the case for contact sports professionals, who are sustaining repetitive TBI.
Injury to Maori—does language hold the key to bringing about change
Authors: Joyce Raihania
Published: October 2012

Background

Maori, the Indigenous peoples of Aotearoa, once prided themselves as injury prevention practitioners. Following their ambitious journey from the mythological homeland Hawaiiki in 925AD, safe practices were imperative for the survival of the Iwi (tribe), in adapting to this new land. Within this collective concept, self-determination was about understandingWhere I had come from, knowing where I was going, And, creating safe pathways to get there.Historically cultural practices recognised that failure to abide by ‘common laws’ could result in severe injury and even death to the individual or the Iwi. Data shows that injury and death by injury for Maori peoples, continues to increase and it is timely that the sector looks to the practices and titles of ‘Te Ao Maori- the Maori World of Old’ to assist in reducing such incidence in this ‘New World’—the 21st century.

Purpose

1. Review relevant historical practices and language of early Maori;

2. Identify contributing factors that have now led to Maori being the perpetrators and victims to New Zealand's injury and death rates;

3. Consider the learning's from this review, informing the design of future research to gain better understanding of Maori attitudes and behaviours around injury prevention practices.

Methods

IPNANZ has produced a report reviewing the literature on what is currently understood about indigenous and Maori attitudes and behaviours around injury prevention practices. Key Maori stakeholders were also consulted to identify gaps in our knowledge of Maori perceptions of injury and injury prevention.

Outcome

The report will form the basis of a research project that aims to fill identified knowledge gaps, and inform future injury prevention programmes for Maori. The findings of this report, and the research that will follow from it, will assist in the reduction of the incidence and severity of injury sustained by Maori in the 21st century.

Contribution to the Field

Self-determination for Maori begins with understanding themselves and the current world that they work, live and play.

Implementation of injury prevention practices is the next step to ensuring that Maori will enjoy the same quality of safe lives as that of other populations in New Zealand.
Patterns and trends in leading causes of unintentional and violence-related injury mortality: United States, 2000–2009
Authors: Rockett IRH , Regier MD , Kapusta ND , Coben J , Miller TR , Hanzlick RL , Todd KH , Sattin RW , Kennedy LW , Kleinig J , Smith GS
Published: October 2012

Background

Trending upwards, the US unintentional and violence-related injury mortality rate needed disaggregation.

Aims/Objective/Purpose

To analyse rate patterns and trends in total injury mortality and its five leading external causes.

Methods

An observational study using negative binomial regression to analyse annual cause-of-death data for US residents for the period 2000–2009 from the Web-based Injury Statistics Query and Reporting System (WISQARS).

Results/Outcome

The mortality rate declined by 25% for unintentional motor vehicle traffic crashes, and increased by 128%, 71%, and 15% for unintentional poisoning, unintentional falls, and suicide, respectively. Suicide is now the leading cause of injury mortality, followed by motor vehicle traffic crashes, poisoning, falls, and homicide, respectively. Females had a lower total injury mortality rate than males (0.39; 95% CI 0.38 to 0.40). Blacks (0.92; 95% CI 0.89 to 0.95) and Hispanics (0.86; 95% CI 0.84 to 0.89) had lower motor vehicular and suicide mortality rates (Blacks: 0.47; 95% CI 0.45 to 0.49) (Hispanics: 0.43; 95% CI 0.41 to 0.45) than Whites, and higher homicide rates (5.55; 95% CI 5.22 to 5.91) (1.92; 95% CI 1.80 to 2.05). The poisoning mortality rate showed a strong time trend; for example, 2009 vs 2000 (1.96; 95% CI 1.75 to 2.20). The fall mortality rate displayed a positive age gradient.

Significance/Contribution to the Field

Suicide, unintentional poisoning, and unintentional fall mortality pose major challenges for prevention in the USA. Suicide has become the leading cause of unintentional and violence-related or intentional injury mortality. Epitomised by successes in motor vehicle traffic safety, injury prevention needs to be evidence-based, proactive, multifaceted, integrated, systematic, flexible, ethically defensible, and sustained.
Minimal Geografical Units (MGU): a new model for injury Geografical Units (MGU) in Costa Rica health surveillance
Authors: Marvin C , Leandra A , Roy W , Guiselle R , Xiomara B , Luis V , Gloria S
Published: October 2012

Background

The need to standardise geographical analysis of the injuries reported by the National Surveillance System has led to development of georeferencing tools nonexistent in our health systems.

Objetive

Develop tools for georeferencing of injury to strengthen the geographical analysis of the data and the identification of risk areas.

Methods

MGU were established from the new cartography national 2011, were standardised MGU of a canton in Costa Rica. It was validated in the field with the primary care technicians (PCT). Was implemented in one canton with high rates of injuries. Were trained PCT and others of institutions involved in the prevention and control of injury using arcview, google earth and microsoft excel.

Results

We developed a geographic analysis tool in Goicoechea, geocoding in 951 MSU (2%) of the all country. It validated the geographic information system with the health centres. Georeferencing the traffic accidents, all types of violence in Goicoechea. We identified three sectors with high-risk and other with medium and low risk, facilitating the monitoring of these events to community level and strengthen decision making and the implementation of strategies.

Contribution to the Field

Such as surveillance and management of injuries is often complex these opportunity to identify geographically these events facilitates the development of strategies community and local teams, improving the scope for prevention and control. One limitation observed in the process was the lack of knowledge of people in the use of digital geographic tools. It is recommended to advance the process to complete throughout the country.
Understanding accident causation in led outdoor activities: development of an accident analysis framework
Authors: Salmon PM , Goode N , Lenné MG , Finch C , Cassell E
Published: October 2012

Background

In Australia, injury-causing accidents during led outdoor activities are currently problematic; however, the industry's understanding of accidents is limited and the surveillance systems required to enhance it do not exist. This paper describes the development of a new accident analysis framework for led outdoor activities.

Aims

The aim of this research was to develop a new accident analysis framework for led outdoor activities.

Methods

Development of the framework was informed by three activities:

1. An analysis of existing led outdoor activity incident data;

2. A review of the accident causation literature; and

3. A review of existing accident analysis methods.

The framework was then tested through analysis of a series of led outdoor activity incidents.

Results

The newly developed accident analysis framework comprises taxonomies of causal factors across the following led outdoor activity ‘system’ levels: Government policy and budgeting, Regulatory bodies and associations, Local area government planning and budgeting and company management, technical and operational management, physical processes and actor activities, and equipment and environment (Rasmussen, 1997). The test applications demonstrate that the framework can be used to identify causal factors across all levels of the led outdoor activity system.

Contribution to the Field

The new accident analysis framework provides a theoretically driven, structured methodology for analysing led outdoor activity accidents. Application of the framework will increase the sector's understanding of accidents, which in turn will support development of more informed and effective countermeasures. The long term contribution will therefore be a reduction in accident and injury rates.
Does pedestrian safety video education influence children's pedestrian route selection: results from a randomised controlled trial
Authors: Shen J , Mcclure L , Johnston A , Schwebel D
Published: October 2012

Background

Pedestrian injuries are a leading cause of paediatric injury. One aspect of pedestrian safety is selection of safe routes across roads. Children often select routes based on expedience but not safety.

Aims

Test efficacy of video-based training on safe pedestrian route selection for children ages 7–8.

Methods

As part of a larger study, 240 children were randomly assigned to one of four groups: video training, virtual reality (VR) training, streetside training, control. Videos included instructions on selecting safe crossing routes; other groups received training in different aspects of pedestrian safety (VR, streetside) or no training (control). All training groups received six 30-minute sessions.

A story task evaluated route selection skills before and after interventions. Children heard four brief vignettes accompanied by graphic representations of streetside locations, then selected preferred crossing routes from three options: distant crosswalk (safest), directly across street without crosswalk (less safe), diagonally across intersection (riskiest).

Results

Among children trained by video, the percentage selecting the safest route in all scenarios increased 56% post-training. For VR, streetside training and control groups, comparable increases were 9%, 19%, −33%. One-way ANCOVA (IV: condition; DV: post-training score; covariates: age, pre-training scores) yielded significant results,F(3211)=3.46, p<0.05. Post-hocs confirmed video group (M=1.85) scored safer post-training than VR (M=2.13, p<0.01) or controls (M=2.06, p<0.05), plus trend with streetside training (M=2.01, p=0.09).

Significance

Video education apparently teaches children safer pedestrian route selection than control groups. It is inexpensive and easy-to-implement, and warrants broad dissemination.
Trends of road traffic accidents in Cameroon between 2007 and 2011
Authors: Sobngwi J , Taniform P , Lagarde E
Published: October 2012

Background

Insufficient valid statistics is a hindrance to the development and implementation of targeted and appropriate interventions to tackle the problem of road traffic accidents (RTAs) in the developing world.

Aims

To undertake a descriptive study of frequency and characteristics of RTAs in Cameroon, from 2007 through 2011.

Methods

We compiled and analysed data from messages of accident reports transmitted by all the traffic police units of the country to the police headquarters. Such messages are transmitted mostly for intercity accidents representing 86% of all reports. The source data comprise the type of crash, type of conflict, the number of people injured and the number of death.

Results

Between 2007 and 2011, the trends in RTA were erratic with 15% increase of killed and 20% of injured in 2008 compared to 2007 and a 13–17% drop in 2009. In 2011, while the number of crashes markedly dropped by 47%, the fatality rate of recorded accidents increased by 40%. Detailed analysis of year 2010 data shows that on average the fatality rate was 58 death/100 accidents, which is at least 10-fold higher than in most developed countries. The most vulnerable road users (VRU) are pedestrians and 2-wheel users representing 27% and 35% of death respectively. In fact, 22% of the recorded accidents involve a car and a pedestrian.

Significance

On average, at least four people per day are killed on Cameroon roads. The saw tooth evolution of RTA numbers and fatality reflect the insufficiency of prevention policy. Efforts to preserve the most VRU are warranted.