bluuebunny/crossref_metadata_2025 huggingface dataset:
Animal bites: what is known and what can be done
Authors: Dixon C A
Published: March 2011

Animal bites account for a large amount of injury and illness worldwide. Types of bite, injury risk and outcomes vary considerably by victim age, animal distribution and disease pathology within the region, and availability of appropriate medical and public health resources.

This workshop will present an overview of the current epidemiology of animal bites to humans worldwide. Based on animal species, victim age and type of bite, common injury risks and outcomes will be identified. A discussion of medical and public health resources necessary to decrease morbidity and mortality associated with these injuries will be reviewed. The necessity for advocacy and research on effective animal bite interventions will be summarised.
Youth homicide in the Americas: a subregional analysis, 1989–2006
Authors: Cerda M , Concha-Eastman A
Published: March 2011

Homicide is one of the leading causes of death for youth aged 10–29 years of age in the America. We reviewed youth mortality data from the America, derived from reliable national civil registration systems, and conducted analyses by subregion, age, sex and time, using semi-parametric group-based modelling to identify clusters of countries that followed similar trends in homicide over time. The age-homicide curve is highest among males: while the homicide rate per 100 000 inhabitants among males ranged from 3.6 at ages 10–14 to 77.9 at 25–29, among women, rates ranged from 1.4 at ages 10–14 to 6.4 at 25–29. Youth homicide rates varied markedly between subregions: the Andean subregion had the highest rates of homicide (3.7–106.5 per 100 000, depending on the age group), and the Latin Caribbean had the lowest rates (0–9.5 per 100 000). Group-based modelling indicated that four to six different types of homicide temporal trends existed in the region, depending on the age group. The most prevalent group of countries (44–57% of the sample) exhibited a stable pattern of low homicide rates, while 5–13% had stable moderate rates of homicide and 2–6% had fluctuating high rates of homicide. Group-based modelling can help us identify the different homicide trajectories that countries follow over time, and evaluate how changing public policies may change regional patterns of homicide and place countries on lower homicide trajectories.
Road safety and security issues among urban cyclists and non-cyclists
Authors: Jain H , Tiwari G
Published: March 2011

Bicycle use varies from 7% to 15% in large cities to 13–21% in medium and small cities in India. It is observed that cyclists are involved in 5–10% of total road related deaths in medium and large cities. The focus of the paper is to highlight differences and similarities in safety among bicycle users and non-users especially among students and low income workers.

This study compares three surveys in Delhi, Pune city and Noida city. About 1500–2000 respondents were interviewed in each city (distributed among students, parents and low income urban workers) and specific questions related to safety and security were asked. Among students, bicycle use varies from 26% to 33% and among poor workers it varies from 75% to 80%.

It was observed that 29% users met with an accident some time or the other while cycling, mostly by M2W and cars, sustaining injuries in one-third of the cases. Among those who use bicycle, 91% identified fear of accident as one of the problems of using bicycle. Though most of the people lock their bicycles, bicycles of 48% people still had been stolen some time in the past, mostly from work place.

As the income and other captive making constraints improve, bicycle riders upgrade themselves to motorised transport due to growing unsafe traffic conditions. These insights can be useful in planning and design strategies to attract the large potential of short trips and convert them in regular bicycle trips.
Study of gaps between precepts and practices in prevention of injuries and prehospital care among injury cases admitted to MS Ramaiah Hospital, Bangalore, Karnataka, India
Authors: Uthkarsh P S , Suryanarayana S P , Gautam M S , Prutvish S , Murthy N S
Published: March 2011

Objectives

(1) To identify the gaps between the precepts and practices of preventive measures and pre-hospital care among the injury cases admitted to MS Ramaiah (MSR) Hospital, Bangalore, India. (2) To find out expenditure incurred during hospital stay.

Study setting

MSR Hospital, Bangalore, India.

Study population

All injury cases admitted to MSR Hospital during the study period.

Study design

Cross-sectional.

Study period

6 Months – October 2008 to April 2009.

Methodology

Data with respect to the sociodemographic characters, preventive measures followed, pre-hospital care provided and the expenditure from the time of admission till discharge collected using pretested questionnaire by interviewing injury cases admitted to MSR Hospital during the study period.

Results

Mean age of injured – 35.3 years (SD=15.38). Among injuries, 69.1% were road traffic accidents (RTAs), 28.7% were falls and 2.2% were burns. Influence of alcohol was found in 14.4% of injuries. Among RTA cases 48.5% had not followed sign board and 56.5% had not obeyed the one way rules, Nearly 73.6% of RTA cases were two wheeler users; 63.5% did not use helmet, 38% had two pillion riders. Whereas 57% of four wheeler users had not used seat belt. Among falls 58% occurred at home, 49% due to slippery surface. Only 26.4% had received first aid; 39% were aware of emergency number. Auto (66.1%) was the common mode of transportation to hospital from the site of injury. Nearly 33.9% had visited more than one hospital before reaching MSR Hospital. Median expenditure (in rupees) of hospital stay was 40 000.
Childhood scald prevention: improvement of electric rice cooker
Authors: Yamanaka T
Published: March 2011

A large number of childhood scald injuries due to electric devices such as an electric rice cooker, an electric pot and a clothes iron occurs at home in Japan. An electric rice cooker is very popular consumer product in Japan since many Japanese people live on rice and then preventing scald injuries due to electric rice cookers is important. Scald injuries due to electric rice cookers are caused by steam with high temperature. According of our investigation, commercialised rice cookers discharge steam with temperature of around 98°C especially when they are boiling rice. In 2006, Childhood Injury Prevention Engineering Council (CIPEC) asked an electric company to improve safety of electric rice cookers by presenting statistical data and detailed situation data of injury due to electric rice cookers based on a hospital-based injury surveillance system that CIPEC developed. To reduce risk of scald injuries, the electric company developed a new mechanism of steam discharge in which the temperature of steam is cooled to below 50°C before the steam is discharged. It is well known that the risk of scald injuries is reduced significantly by decreasing the temperature to less than 50°C. The cooling mechanism consists of a fan that can reduce steam temperature by changing the energy of steam with high temperature into the rotational kinetic energy of the fan. A new type of electric rice cooker with this cooling mechanism was commercialised in June 2009.
Building a traffic accidents epidemiological surveillance system
Authors: Ungaro J F , De Hoyos G H , Ubeda C
Published: March 2011

Introduction

Good quality information regarding traffic injuries is hard to find and difficult to produce. A traffic accidents epidemiological surveillance system was designed in Neuqun, Argentina. Its implementation and evaluation are described.

Material and methods

Interviews were carried out with 20 key informants in order to investigate on sources and information course. Eight focal groups were constituted to establish the case definition and the variables. An instrument was designed to obtain the information related to each event and its victims, which was incorporated in two related databases. The attributes of the system were evaluated by seven focal groups and a qualified professional discussion group.

Results

Three sentinel sites and one sentinel unit were organised. 33 registration centres were established in total. Data were obtained regarding when and what time, where, and how, for each accident, vehicles involved, environmental factors, and number of victims. The victims info includes: age, sex, place of residence, role in the event, use of safety equipment, alcohol drinking and consequences. During the first year 453 events and 739 victims were registered. Risk maps for each region were obtained. The system was considered effective; its attributes (acceptability, simplicity, delivery and use of information, opportunity, sensitivity, flexibility, representativeness and positive predictive value) were highly qualified.

Discussion and conclusions

A system built cooperatively by its own users has a great acceptance. Coordination with an action programme is essential. The experience was a very important antecedent for the implementation of the current National Injury Surveillance System.
Comparing Bayesian network, artificial neural networks, classification trees and classical logistic models in quantitative risk assessment: an application to the European Registry of Foreign Body Injuries in Children
Authors: Gregori D , Berchialla P , Foltran F
Published: March 2011

Risk assessment is the systematic study of decisions subject to uncertain consequences.

An increasing interest has been focused on modelling techniques like Bayesian networks (BNs) since their capability of (1) combining in the probabilistic framework different type of evidence including both expert judgements and objective data; (2) overturn previous believes in the light of the new information being received and (3) making predictions even with incomplete data.

In this work we proposed a comparison among BNs and other classical Quantitative Risk Assessment techniques such as neural networks, classification trees and logistic regression. Hybrid approaches, which combine classification trees and BNs, are also considered. Among BNs a clear distinction between purely data driven framework and BN which are built using expert knowledge is made.

The aim is directed to evaluate among this set of Quantitative Risk Assessment tools which best can be applied to assess the safety of children who are exposed to the risk of inhalation/insertion/aspiration of consumer products. The issue of preventing injuries in children is of paramount importance, and in particular in fields where product design is involved, a proper risk assessment can be of great usefulness. Data of the European Registry of Foreign Bodies Injuries are a valuable set of starting evidence to build up such risk models.

Results showed that BNs appeared to have both the easy of interpretability and accuracy in making classification, thus outperforming other methods.
North-south collaboration on research and advocacy to reduce armed violence
Authors: Pinto A D , Crespin E , John I , Mtonga R , Valenti M , Zavala D
Published: March 2011

Armed violence is a global problem, yet disproportionately impacts certain nations. In recent years, approximately 90% of all direct conflict deaths occurred in low-income countries in Asia, Africa and Latin America. The situation for indirect deaths is even more disproportionate. Further, the South contains almost all countries that are considered to have active conflicts or are post-conflict, related in part to a shared history of colonialism and underdevelopment. Finally, advocates and academics in the South face greater personal risks than those in the North when speaking out against armed violence, particularly if it involves being critical of political forces. Despite this situation, much of the research and advocacy on armed violence originates from universities and organisations in the North. This is particularly the case when looking at funding, leadership and the initiation of projects.

This paper will identify best practices of North-South collaborations on armed violence research, education and advocacy. Precedent exists within research, particularly the work of International Physicians for the Prevention of Nuclear War, the Red Cross and other large medical non-governmental organisations. Similarly, best-practice examples of advocacy can be explored that demonstrate effective North-South collaboration.

Future work would benefit from a clear definition of partnership, developing broader networks and working towards a South-driven movement. Support should focus on improving Southern access to resources, as identified by these partners. In addition, Northern partners should prioritise examining and changing the role their societies play in sustaining armed violence in the South.
Risky driving behaviours of three-wheeler drivers and three-wheeler crashes in Sri Lanka: a case–control study
Authors: Jayatilleke A U , Poudel K C , Dharmaratne S D , Jayatilleke A C , Jimba M
Published: March 2011

Objectives

In this study, we examined the association between risky driving behaviours of three-wheeler drivers and three-wheeler crashes in Sri Lanka.

Methods

We conducted a case–control study in Kandy, Sri Lanka between August 2008 and March 2009. Cases were all the three-wheeler drivers involved in crashes in Kandy between 1 January and 31 December 2007 (n=95). We included two control groups: a control group matched to the age of the cases (n=88), and a control group matched to the sites of the crashes (n=82). We used the Manchester Driver Behavior Questionnaire (DBQ) to examine the risky driving behaviours of the drivers. Using the multivariate logistic regression analysis we examined the association between risky driving behaviours and three-wheeler crashes.

Results

The DBQ revealed three types of risky behaviours of three-wheeler drivers: intentional violations, dangerous errors and violations due to drivers hurry. The violations were associated with three-wheeler crashes: intentional violations (control-1 adjusted OR (AOR)=2.18, 95% CI=1.30 to 3.64, control-2 AOR=2.38, 95% CI=1.32 to 42.61), violations due to drivers hurry (control-1 AOR=1.84, 95% CI=1.11 to 3.05, control-2 AOR=2.20, 95% CI=1.29 to 3.73). Driving errors, however, did not show an association with three wheeler crashes (control-1 AOR=0.62, 95% CI=0.34 to 1.11, control-2 AOR=0.86, 95% CI=0.55 to 1.33). Following variables also showed significant associations with three-wheeler crashes: obtaining driving license through private driving schools, carrying more than three passengers in the rear seat, daily mileage above 80 km and driving experience of less than 6 years.

Conclusion

Road rule violations by three-wheeler drivers were associated with three-wheeler crashes in Sri Lanka.
Assessing the cost-effectiveness of conventional group based exercise and Tai Chi as interventions to reduce the risk of fall-related injuries in older people
Authors: Park A , McDaid D
Published: March 2011

Objective

To determine whether there is an economic case for investment in group exercise programmes or Tai Chi compared with recommended multi-factorial programmes as protective interventions against the risk fall-related injury in older people.

Methods

A decision analytic model compared costs and effects of conventional group exercise, Tai Chi and multi-factorial interventions for individuals aged 65+. A literature review identified parameters for the model, including risk of falling and sustaining injury, quality of life, costs of interventions, health service use and institutionalisation risk. The economic analysis was conducted from a health and social care perspective, using 2008 UK pounds. The main outcome was incremental cost per quality-adjusted life-year (QALY) gained. To explore uncertainty sensitivity analyses were run varying effectiveness, cost and utility gains associated with the interventions.

Results

Participation in Tai Chi classes was shown to dominate investment in multi-factorial fall prevention strategies and conventional group exercise with both lower expected costs (1087 vs 1190 or 1255 per participant) coupled with a small increase in quality of life. Our results remained robust in sensitivity analysis. In the worst case scenario the cost per QALY gained using Tai Chi was 14 899, a value considered highly cost effective in the UK healthcare system.

Conclusions

Our economic analysis suggests that both exercise and Tai Chi are potentially cost effective intervention strategy for the prevention of fall related injuries in community dwelling older people.
Public health midwives perceived barriers to identify intimate partner violence (IPV) and their identification of IPV victims in Sri Lanka
Authors: Jayatilleke A C , Poudel K C , Fernando N , Yasuoka J , Jayatilleke A U , Jimba M
Published: March 2011

Objectives

We assessed the association between public health midwives perceived barriers to identify intimate partner violence (IPV) and their identification of IPV victims in Sri Lanka.

Methods

We carried out a community-based cross-sectional study in the Kandy district, Sri Lanka between August and September 2009. Participants were all the public health midwives in the Kandy district (n=425). We collected data on midwives identification of IPV victims during the past 3 months, and their agreement to six possible barriers for the identification of IPV. We analysed data using the multivariate logistic regression analysis; we adjusted the six barriers for midwives work duration, education and marital status.

Results

Of the 425 midwives, 48 (11.3%) reported that they did not identify any IPV victim during the past 3 months. Midwives were less likely to identify IPV victims if they agreed that I don't have adequate knowledge to detect or help IPV victims (adjusted OR (AOR)=0.30, 95% CI=0.12 to 0.73), or I don't feel that I can help an IPV victim (AOR=0.17, 95% CI=0.07 to 0.43). However, we did not observe such an association between the following barriers and midwives identification of IPV: my work load is too much, women are always accompanied by someone, asking on IPV might offend women and though identified, there are no supportive services for IPV victims.

Conclusions

Sri Lankan midwives were less likely to identify IPV victims if they perceived that they do not have an adequate knowledge or the ability to identify and support the IPV victims.
Risk posed to children by stationery items in the upper airways: evidence emerging from the ESFBI study
Authors: Foltran F , Berchialla P , Gregori D , Pitkranta A , Slapak I , Jakubkov J , Bellussi L , Passali D
Published: March 2011

Rationale and aim

The insertion, inhalation, aspiration or ingestion of a foreign body (FB) is a relatively frequent event in young children. Some classes of objects such as stationery items (including pencils, pens and their parts etc), are frequently listed in clinical registries among commonly inserted, inhaled, aspirated or ingested objects but rarely receive a specific attention.

The aim of the present study is to characterise the risk of complications and prolonged hospitalisation due to stationery items according to age and gender of patients, FB characteristics and FB location, circumstances of the accident, as emerging from the ESFBI study.

Methods

A retrospective study in major hospitals of 19 European countries was realised on children aged 0–14 having inhaled/aspired or ingested a stationery item, with regard to the characteristics of the child and the FB (shape volume consistency), the FB location the hospitalisation's details and the occurrence of complications.

Results

In the years 2000–2003 a total of 2094 FB injuries occurred in children aged 0–14 years. Among them 62 (3%) were due to a stationery item: 32 were due to objects insertion in the ears while 30 occurred in the upper and lower respiratory tract. Objects most frequently involved are parts of pens in children younger than 3 years and eraser in older. 39% of children needed hospitalisation. The most documented complication was inflammation of external ear. Almost 24% of injuries happened under adults supervision.

Conclusions

Injuries are events that in many cases can be prevented with appropriate strategies. Passive environmental strategies, including product modification by manufacturers, are the most effective. However, regulation regarding small parts of potentially dangerous objects, covers products addressed to children use but objects not projected for children, such as stationary items, are excluded. Our study testifies that stationary is involved in a non-negligible percentage of FB injuries, mainly due to insertion in the ears. Frequently, injuries happens under adult supervision. This results confirm the fact that when passive preventive strategies are not practical, active strategies that promote behaviour change are necessary and information about this issue should be included in all visits to family paediatricians.
Foreign bodies causing asphyxiation in children: the experience of the Buenos Aires Pediatric ORL Clinic
Authors: Chinski A , Foltran F , Passali D , Bellussi L , Gregori D
Published: March 2011

Rationale and aim

The inhalation/aspiration, of a foreign body (FB) is a relatively frequent event in young children. Size, shape, type and site of arrest of the FB are responsible of an important variability on clinical picture, therefore, the possibility to know details regarding object characteristics and traumatic event dynamics have a key role. In the present paper, experience coming from the Children's Hospital in Buenos Aires, Argentina, is presented and our observations are compared with information coming from four well known case series already published and chosen as representative of other cultural and geographical background.

Methods

A prospective study in Children's Hospital Gutierrez, Buenos Aires, Argentina, was realised on children having inhaled/aspired a FB, with regard to age and sex distribution, FB type, dimensions and consistency, FB location, clinical presentation, removal and occurrence of complications.

Results

Over 1 year, 65 cases of FB inhalation were observed. The children mean age was 4.03 years (SD 1.93). Injuries happened in the major part of cases at home (53 cases (81.53%)) and under adult supervision (59 cases (90.76%)). Children frequently inhale small objects having a rigid consistency. Although the most frequent FB are nuts, differently from other cases series in which injuries are commonly due to food inhalation or aspiration, the major part of accidents in our experience are related with the inhalation of an inorganic FB. Observed complications were pneumonia (3 cases), atelectasis (2 cases) and pneumonitis (1). No deaths were recorded.

Conclusions

The high frequency of inorganic FB related injuries testifies that children have the possibility to play with objects, such as pins and nails, not adequate for their age and adults are non-conscious of the choking risk associated with some objects or behaviours. In fact, often injuries happen under adult supervision. Unfortunately, in scientific literature data regarding the dynamic of the accident and particularly the adult presence are frequently underreported; however, when information is at a disposal, it confirms the idea that more effort in caregivers' public education is needed and that information about this issue should be included in all visits to family paediatricians.
Circumstances of injury in childhood and adolescence: current data and epidemiology
Authors: Ellsaesser G , Albrecht M
Published: March 2011

We investigated the population-related and social aspects of injuries in children and adolescents. In contrast to clinical case studies our focus was on risk groups, injury mechanisms and context of injury. Sources of information used for our study included: Causes of Death Statistics, Hospital Diagnosis Statistics, Child and Adolescent Health Survey, Injury Data Base. We compiled data from the period 1998 to 2007 on unintentional injuries, violence and suicide by age group and sex and included study results on social and ethnic risk factors. Our analysis revealed that injuries display an age-specific dynamic: infants carry a high risk for fatal domestic injuries as well as for injuries due to violence, whereas in adolescents the majority of injuries results from fatal traffic accidents and from suicide. In addition, we found that social factors affected specific mechanisms of injury (eg, scalding) and intention (eg, violence) only. A migration status had an age- and sex-related influence on injury rates.
Locally developed electronic trauma registry: a novel solution for low-income settings
Authors: Mehmood A , Razzak J A , Raza S , Mumtaz N , Ejaz K
Published: March 2011

Introduction

A functionally active and well organised electronic trauma registry (ETR) can assist in addressing important issues about the prevention and treatment of injuries at hospital and regional level. The ideal process of development of such a registry includes its customisation according to the local needs and enabling the end users to give their feedback to the software programmers who can improvise it accordingly. Examples of ETRs in low and middle income countries are rare, mainly due to cost of obtaining and maintaining such registries. This prompted us for development of a local registry with the help of software programmers at a low cost with a user friendly interface.

Attributes

The ETR uses both hardware and software to collect, verify, store and analyse the data. Effective coding systems for example, International Classification of Diseases (ICD-9-CM) and Abbreviated Injury Scaling (AIS) aid in standardisation of the terms, whereas backend spreadsheets and calculators help in storage, collation and analysis of the data.

Scope

Information about patient demographics, injury location, injury date and time, external causes of injury, injury modifiers, mode of transport, ED/hospital assessment and treatment, final diagnosis, disposition and outcome can be recorded. The registry is capable of generating different trauma scores (GCS, RTS, ISS) and probability of survival (TRISS) score.

Advantages

The registry could be used for hospital based injury surveillance, trauma outcome research and public policy interventions. When applied in multiple hospitals, it will serve as a city-wide trauma data bank.
Dog bite injuries a preventable hazard?
Authors: Butcher R , De Keuster T
Published: March 2011

Estimates indicate 1.5% of the population is bitten by a dog annually (though probably 50% of bites remain unreported), and that the incidence is increasing. However, dogs are popular pets associated with scientifically proven health and social benefits for their owners and their families. It is important to devise bite prevention strategies that preserve these benefits while reducing the risk of injuries.

Contrary to the popular view that the problem is restricted to a few so-called dangerous breeds, evidence indicates that most bites occur within the home, most often in young children bitten by a familiar dog. These incidents therefore reflect a significant cause of accidents to children in the home that can be prevented.

Within the home, 86% of the bites appear to be triggered by a dog/child interaction initiated by the child. However, the majority of bites occurring in public places happen without previous interaction from the victim. The tendency of a dog to bite depends on multiple interacting factors including those related to the individual dog and the individual victim, but importantly influenced by the sociocultural context.

In conclusion, more research is needed on the epidemiology of bites to help identify the most appropriate prevention strategies. These should focus on the context rather than simply on dog attack records. The research and future implementation of strategies will require coordination and involvement of all major stakeholders, but it seems clear education (of both healthcare professionals and general public) will be the key.
The effectiveness of a culturally sensitive burn and fire prevention program designed for inner city school students and parents
Authors: Rimmer R B , Pressman M , Joiner J , Winchester S , Foster K N , Caruso D M
Published: March 2011

Introduction

Injury prevention has become a major healthcare priority. Burns, a leading cause of death in children, often occur in minority based, lower socio-economic neighbourhoods. This study sought to determine if targeted fire/burn prevention curriculum, delivered in an at-risk school system could teach and sustain prevention knowledge in elementary students.

Methods

A 60-page prevention curriculum for grades 1 through 6 was presented with two 32-page, picture story books regarding scald prevention and family fire safety. A packet of alphabet childhood injury/safety cards was also included. Parent materials were provided in Spanish and Somalian. Students completed a pretest assessing fire safety and burn prevention knowledge. A post-test was administered at the completion of the grade appropriate curriculum and again at 6 months postinstruction.

Results

Students (681) median age 8, Hispanic (98%), (1%) Caucasian and 1(%) African American & Somalian, completed pre-post and post-post tests. Students, after receiving materials and curriculum, showed significant improvement in documented knowledge from pre to post-test (p < 0.001). Post/post tests results, completed 6 months later, showed sustained learning for all grades(p < 0.001).

Conclusion

Culturally sensitive programs which deliver prevention information to children and parents through entertaining and repetitive story, helps to heighten health literacy and successfully deliver critical safety information to families. The books and cards, which were given to each child for home usage, were likely read repeatedly. This appears to have sustained learning and effected knowledge retention well beyond initial classroom instruction.
Pretest of a locally developed trauma registry
Authors: Mehmood A , Ejaz K , Razzak J A
Published: March 2011

Introduction

Electronic trauma registries (ETR) play a critical role in the collection of pre-hospital and hospital based trauma data, required for trauma care improvement. The crucial step is to have a functionally active and reliable trauma registry which is customised according to the local needs. This prompted for development of a low cost local registry with the help of software programmers.

Objectives

To pretest locally developed ETR at a single university hospital, to assess the functionality, efficiency and reliability in data storage retrieval and analysis.

Methods

We tested the registry with records of poly-trauma patients treated during 2008 at Aga Khan University Hospital. This data was entered into the ETR, by trained staff, its functionality and reliability was assessed through analysis of the data.

Results

There were 119 patients, with mean age of 32.7 years, mean RTS was 7.48650, ISS score was 12.039 and mean TRISS was 95.7511. The most common mechanism of injury was MVC (73.1%) followed by gunshot wounds (16.8%). There were 5 (4.2%) patients who expired. In the analysis of injuries, head and neck (42%) and extremities (52.1%) were the most commonly involved regions. We found that there were four unexpected deaths (TRISS > 50%) and we also found two unexpected survivors (TRISS <50%).

Conclusion

The ETR is found to be a reliable data storage system which is also capable of generating standard reports consisting of patient demographics, injury severity scores and probability of survival and outcome.
Experience of physical, emotional and sexual violence and adverse health behaviours in Macedonian students: results from the adverse childhood experience survey
Authors: Raleva M , Pesevska D J , Sethi D , Hadzihamza K , Filov I , Boskovska M
Published: March 2011

Objective

To examine associations between experience of physical violence, sexual violence and emotional violence and adverse health behaviours among a sample of students in Republic of Macedonia.

Methods

In a cross-sectional analysis of data from high school and university survey in Republic of Macedonia educational institutions that participated in the adverse childhood experience survey in 2009–2010 we compared the relative frequency of several adverse health behaviours among students (primarily students 18–20 years of age) who did or who did not report experience of PV, SV or EV. We estimated ORs for such behaviours and theirs 95% CIs after adjusting for age and sex.

Findings

Experience of physical violence in childhood was reported by 25–32% of the students studied in several regions in Macedonia, and experience of sexual violence was reported by 9–12%. Emotional abuse was reported by 37–43%. Moderate to strong associations were observed between adverse childhood experience of physical violence and sexual violence and measures of mental health, suicidal ideation, cigarette smoking, alcohol or substance abuse, multiple sex partners.

Conclusion

Childhood experience of physical violence, emotional violence and sexual violence is common among Macedonian students and is associated with multiple adverse health behaviours. In developing country such as Macedonia, increased awareness of the frequency of experience of violence among children and its potential adverse health consequences may lead to heightened attention to the need for preventive programmes that address the problem.
Injuries in German professional ice hockey epidemiology and prevention
Authors: Kelp J , Luig P , Klein C , Kantner F , Schulz D , Moser N , Henke T
Published: March 2011

Ice hockey differs in dynamic, allowed body contact and equipment from other team sports, probably leading to a higher injury risk. Thus, ice hockey captures the first place of the injury statistics in German professional team sports. Therefore, the aim of this study was to analyse the epidemiology in German professional ice hockey and to elaborate appropriate prevention measures.

The underlying database considers DEL players and describes injuries, resulting disabilities and costs. Additional information concerning injury situations and mechanisms was collected by means of a questionnaire-based survey. Between July 2007 and June 2008 professionals, who registered injuries received a questionnaire for detailed description of the accident. 914 injuries causing costs were registered. Response rate reached 12.4%.

Thus, each DEL player sustains an average of 2.6 injuries per season. Half of those injuries lead to temporary incapacity for work. The other half merely causes treatment costs. Nine of 10 players sustain at least one injury per season. The injury list permanently contains 25% of all DEL players. Injury costs including treatment costs and lost staff costs amount to 8 million per year. 54% of all costs are allotted to knee (24%), head (16%) and shoulder injuries (14%). Remarkably, 67.2% of irregular actions leading to injuries had not been judged as a foul by the referee.

Elaborated preventive measures focus on protective equipment, training measures concurrently reducing injuries and enhancing performance – in particular checking performance, revised education of referees, consistent penalisation and fair play.
Suicide attempts in French prisons: results of the TARTARE survey
Authors: Encrenaz G , Miras A , Contrand B , Pujos S , Galera C , Michel G , Lagarde E
Published: March 2011

Objectives

To describe suicidal behaviours in prisons and to determine factors associated with suicide attempts during imprisonment.

Methods

All inmates of a prison for prisoners awaiting trial (Bordeaux, France) were eligible for this cross-sectional study. 375 inmates have been face-to-face interviewed by an experienced psychologist. Sociodemographic data, imprisonment conditions, health status and healthcare utilisation, mental health, impulsivity, aggressiveness, interpersonal violence (victim and perpetrator status) and suicidal behaviours were documented.

Results

The incidence of suicidal attempts during imprisonment was equal to 12.9 per 100 persons-year. Having made a suicide attempt during imprisonment was associated with being victim of violence without perpetrating it (adjusted OR=7.5), having children (adjusted OR=3.5), suffering from depressive and anxious symptoms (adjusted OR=3.4) and complaining about the prison noise (adjusted OR=3.7). Other factors, in particular a personal history of suicide attempts, were not associated with the risk of suicide attempts during imprisonment.

Discussion

The major risk factor of suicide attempts was being victim of violence. These results could help to improve screening checklists of inmate suicide risk already used in prisons. However, all data were self-reported but have been improved using data recorded by the prison administration when they were available.
Participation and injuries in organised sports in Germany: a longitudinal study covering the years 1987–2009
Authors: Klein C , Luig P , Schulz D , Henke T
Published: March 2011

Following the Resolution on Sport for All: injuries and their prevention in 1986 the Department of Sports Medicine of the Ruhr-University Bochum and the ARAG Sports Insurance established a database of sports accidents. For over 20 years this cooperation has intended to reveal focal points of accidents on the basis of statistically verified and representative data. Furthermore, the development of preventive approaches with targeted measures suited to specific sports has always been a pivotal aim. Athletes that have reported a sports accident to the sports insurance company have been asked to fill in a questionnaire relating to the course of the accident, the injury and its treatment as well as the amount of organised and unorganised sporting activities. The response rate is approximately 50%. The collected data covers more than 180 000 sports accidents between 1987 and 2009. Thus it is one of the largest sports injury databases in Europe.

The aim of this study is to consider the progress of the accidents and to highlight the main changes of sports injuries in comparison with the number of participants within German sports associations, finally leading to the elaboration of prevention measures. The focus is on sports with the highest absolute number of injuries. In fact football is the leading sport in Germany concerning the number of injuries and participants. It is outstanding that 75% of all organised sports injuries are registered in football, handball, basketball and volleyball, although only 30% of all sports club members are organised within these sports.
Implementation of evidence-based interventions to prevent drowning: results from a WHO collaborative project
Authors: Mitis F , Sethi D , Racioppi F
Published: March 2011

Introduction

34 000 drowning-related deaths are observed yearly in WHO European Region. Rates in low- and middle-income countries are six times higher than in high-income countries.

Methods

A questionnaire survey was undertaken as part of a collaborative project between WHO and the European Commission on progress achieved by Member States in implementing the WHO resolution and the European Council Recommendation on the prevention of injuries. Information was used on the implementation of eight evidence-based interventions to prevent drowning. Countries were grouped according to geographical location. Mortalities for drowning were examined by country grouping and correlated with level of implementation of interventions at a subregional level.

Results

There were responses from 47 of the 51 Member States with focal persons. Regional median implementation of drowning prevention interventions was 63% (IQR: 38–75%). The average mortality for the Baltic countries is six times higher than that for Nordic countries for both sexes. Implementation was variable across groups: 81% in Nordic countries, 73% in southern countries, 70% in CIS, around 50% in western, central and southeastern countries, only 8% in the three Baltic countries. In particular, no interventions were implemented in Lithuania and Latvia, only 25% in Estonia.

Conclusions

An inverse correlation can be observed between the implementation of evidence-based interventions and mortality for drowning in European countries when subregions are considered. The health sector needs to take a leadership role in advocating for the widespread implementation of effective programmes and to engage with other stakeholders in a multisectoral response to prevent drowning.
Violence experience and quality of life in primary schools in Hamburg, Germany
Authors: Schillmoeller Z , Erhart M , Ravens-Sieberer U
Published: March 2011

Violence in schools (bullying) has repeatedly been in the focus of societal discussions. Public health studies were primarily conducted in secondary schools. This study is the first one in Germany which informs about experiences with violence, practicing violence and attitudes towards violence in primary school children in Hamburg.

In November 2005, a cross-sectional survey was conducted in which 1154 primary school children of the third and fourth grade answered a quantitative questionnaire concerning the above issues. In addition to bi- and multivariate analysis, Structural Equation Modelling was conducted to analyse the association between the main latent outcome variables bullying and quality of life.

The results show that bullying in primary schools is a common problem. 20% of the third and fourth graders reported having been bullied at least once a week. 5–7% of children admitted to have bullied someone once a week. 25% of the school children reported feeling a low subjective quality of life. While school climate and social support by friends and peers was associated with bullying, gender and socioeconomic conditions did not show any significant association. Only 50% of pupils reported that they would inform adults about their current bullying situation.

In conclusion, to improve the violence situation in schools factors influencing the school climate particularly the relationship between teachers and students, needs to be enhanced because these factors in turn influence the social support between the children, thereby preventing or decreasing bullying experiences and improving the subjective quality of life in children.
Association of provisional driver licensing intervention by police with changes in incidence and severity of road traffic injuries in Iran
Authors: Ainy E , Soori H , Nasermoadeli A , Movahedi M , Mehmandar M R , Mahfozphoor S , Masoodeinejad M R , Hatamabadi H R , Azari M Rezazadeh , Vafaee R
Published: March 2011

Objective

This study was conducted to evaluate the role of provisional driving license implemented by the traffic police of Iran on reducing the incidence and severity of road traffic injuries.

Methods

It was a before-after interventional study. Data on road traffic crashes and injuries from 1 year before, 1 and 2 years after the implementation of provisional driver licensing were obtained from the traffic police database. After data cleaning and stratification of traffic injuries and mortalities, the implementation of graduate driver licensing compared in those in early years of their driving experience.

Results

Drivers under 23 years of age consisted 22.8% of total road traffic injuries (RTIs) in the year prior to the implementation of graduate driver licensing. This proportion reduced to 15.5% and 16.1% in the first and second year after the intervention, respectively, among holders of provisional B1 type driving license (p<0.001).

Conclusion

This intervention was effective in reduction of number and intensity of traffic injuries. Young and novitiate drivers are at high risk of RTIs. Provisional driving license program might be a key factor to reduce the incidence and severity of road traffic injuries among them.
Gender-based violence against female pupils at a high school in northern Zambia
Authors: Mtonga R E
Published: March 2011

Gender-based violence was commonly directed against female pupils by teachers and male pupils using non-consensual sex, corporal punishment and abusive language. The victims didn't report the matter for fear of reprisals.

Results

The pupils were aged between 10 and 21 years (with majority between 16 and 20 years old) and equal gender representation. 29 (58%) pupils reported being sexually abused by teachers, 29 (58%) cited corporal punishment 27 (56%) ticked abusive language. In 27 (54%) cases, teachers were the main perpetrators, while 22 (44%) pointed at classmates. 10 (43.5%) did not report the matter. Reasons included fear of being expelled from class, the teachers lose their jobs (2 or 8.7%), feared retaliation from fellow classmates and 2 (8.7%) felt sited cultural taboos. In reported cases 8 (29.6%) showed no action was taken and 4 (14.8%) didn't hear any further from the authorities. Five (10%) had unwanted pregnancies, 4 (8%) had contracted sexually transmitted infections. 38 (76%) felt depressed, with 15 (30%) feeling like skipping class and another 2 (4%) contemplating suicide.

Discussions and Conclusions

Gender-based violence was mainly perpetrated by teachers and pupils against female pupil. Abused pupils feared reprisals hence did not report the matter and when reported no appropriate action was taken. Consequences of gender-based violence included depression, contraction of sexually transmitted infections, unwanted pregnancies and suicidal thoughts.
The feasibility of different task combinations for the assessment of dual task performance in community-dwelling fallers and non-fallers
Authors: Muhaidat J , Skelton D A , Kerr A , Evans J J
Published: March 2011

Background

Poor performance on Dual Task (DT) tests has been identified as a risk factor for falls in older adults.1 There is no consensus on which DT combination best predicts falls.2 Moreover, there is a discrepancy between what older adults perceive as difficult and fall inducing DTs and DTs used in the literature.3

Aims

To explore the feasibility of DT tests from the point of view older adults, and to reduce the number of possible DT combinations.

Method

Sixteen fallers and sixteen non-fallers. Inclusion criteria were as follows: age≤65 years, community dwelling and functionally independent. 49 DT tests were assessed. Examples of the primary tasks used were walking, walking with obstacles and stairs descent. Examples of the secondary tasks were: arithmetic, auditory and visuospatial. Primary and secondary tasks were combined. A questionnaire (10 questions) was administered after each test to assess the feasibility of each test. Questions addressed test difficulty, instructions and relevance to everyday life. DT decrements in the performance of the primary and secondary tasks were measured.

Results

Results will be presented.

Conclusions

This study will draw important conclusions on which DT tests can be used in practice to prospectively assess falls risk in older people.