bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidemiology of injuries requiring surgery among US high school athletes
Authors: Rechel J A , Collins C L , Comstock D
Published: March 2011

Background

The proportion of high school sports-related injuries requiring surgery has significantly increased during the last decade. These injuries pose significant monetary and time loss burdens to young athletes.

Objective

To investigate the epidemiology of US high school athletic injuries requiring surgery and to compare the rates and patterns of these injuries by sport, type of exposure and gender.

Methods

Sports-related exposure and injury data were collected during the 2005–2009 academic years from a nationally representative sample of 100 US high schools via RIO. Results: In the nine sports studied, 1106 injuries requiring surgery occurred during 7 740 400 athlete exposures (AE) for a rate of 1.43 injuries per 10 000 AE. Injuries requiring surgery accounted for 6.2% of all high school sports-related injuries. The rate of injuries requiring surgery was higher in competition (3.15) than practice (0.79) (RR 3.99; 95% CI 3.54 to 4.50; p<.001). The most common body sites of injuries requiring surgery were the knee (46.0%), head/face/mouth (10.5%), and shoulder (9.2%). Girls sustained a greater proportion of knee injuries (68.7%) than boys (36.6%) (IPR 1.88; 95% CI 1.86 to 1.89; p<.001). The most common diagnoses for injuries requiring surgery were complete ligament strain (30.6%), fracture (26.8%) and torn cartilage (10.7%). 50.5% of injuries requiring surgery resulted in medical disqualification for the season.

Conclusions

Rates of patterns of injuries requiring surgery differ by sport, type of exposure and gender. Future studies should identify sport-specific risk factors to help develop and assess effective interventions to decrease the incidence and severity of high school sports-related injuries.
Identifying modifiable environmental risk factors for falls in older people
Authors: Faulkner S , Burns D
Published: March 2011

Background

With the number of people over the age of 60 growing more than any other population group the issue of falls among the elderly is a growing safety concern. WHO figures show that approximately 28–35% of those aged ≤65 fall each year with significant socioeconomic and health impacts. The issue of outdoor falls in the elderly is under-researched in comparison to falls in the home.

Methods

A systematic review of modifiable outdoor environmental risk factors highlighting the importance of footwear as an interface between the individual and the outdoor environment for the prevention of falls.

Findings

Despite the limited amount of time that older people spend outdoors walking is the activity during which the highest proportion of older people falls, citing an uneven surface or tripping as the cause of the fall. Nearly 70% of active elderly adults report walking as their predominant choice of physical activity. This group have been identified as being at greatest risk of an outdoor fall. When four or more risk factors are identified the potential for a fall significantly increases. It has been suggested that simple effective measures such as appropriate footwear, maintenance of outdoor walking surfaces, improved lighting, additional seating and clearing footpaths frequently of debris and snow may reduce the number of outdoor falls.

Conclusion

Identification and reduction of environmental risk factors is thought to reduce the potential for falls. However, this literature review shows that the evidence is inconclusive and highlights the need for further research in this area.
Alcohol use and violent injury in Uganda
Authors: Wandera B , Nakiito M , Lett R
Published: March 2011

Background

Alcohol consumption is associated with increased risk of injury. Uganda has the highest alcohol consumption per capita. There is paucity of information about alcohol consumption and injury in Uganda. Moreover this information is relevant in designing appropriate injury prevention interventions.

Objective

To compare injuries by pre-injury alcohol consumption history.

Methods

Data were collected between January and December 2009 at emergency departments of five regional referral hospitals from patients presenting with injuries. Analysis for alcohol use restricted to subjects aged above 15 years.

Results

Of 3572 injury patients, 2456 patients were above 15 years of whom 307(12.5%) reported alcohol use before the injury. Persons reporting alcohol use were more likely to be male, 15% versus 6%, p< 0.0001, to have intentional injuries 14.4 versus 6.1%, p<0.0001, seen in city hospital 12.7% versus 8%, more likely to be brought by police to hospital 18.6% versus 8.3%, with concussion/coma, 19.5% versus 10.8% and more likely to be admitted, 15.5% versus 10.5% p= 0.0002 but less likely to be involved in a road traffic injury (10.5% vs 14.5% p= 0.002). 80% of the intentional injuries were due to interpersonal violence. There were no differences by age nor number of serious injuries sustained.

Conclusions

Alcohol use was associated with intentional injuries and is a contributing factor in severe intentional injuries among males in urban areas. Counselling, education and regulation of alcohol consumption needs strengthening.
Epidemiology of dislocations/separations among US high school athletes
Authors: Kerr Z Y , Collins C L , Comstock D
Published: March 2011

Background

As participation in US high school sports increases, the number of student-athletes sustaining dislocations/separations may similarly increase. Many dislocations/separations are recurring, require surgery and have long recovery times.

Objective

Investigate the epidemiology of dislocations/separations in a nationally representative sample of US high school athletes.

Methods

Sports-related exposure and injury data were collected during the 2005–2009 academic years from a nationally representative sample of 100 US high schools via RIO.

Results

In the nine sports studied, athletes sustained 755 dislocations/separations during 7 740 400 athlete exposures (AE) for a rate of 0.98 injuries per 10 000 AE. Dislocations/separations represented 3.6% of all high school athletic injuries. Overall, males had a higher dislocation/separation rate (1.30) (RR 3.91, 95% CI 3.12 to 4.89, p<.001) than females (0.33). However, among sports in which both males and females participated (ie, soccer, basketball, baseball/softball), rates of dislocations/separations for males (0.39) and females (0.34) did not differ (p=.406). Body parts most commonly injured were the shoulder (54.9%), wrist/hand (16.5%) and knee (16.0%). 18.4% of dislocations/separations were recurrent; 11.8% required surgery; and 62.2% of athletes returned to play in 3 weeks or less. The majority of dislocations/separations were sustained from contact with another player (52.4%).

Conclusions

Developing effective sport-related preventive measures depends upon increasing our knowledge of dislocation/separation rates, patterns and risk factors.
Injury rates in Canadian Ontario first nation communities
Authors: Macpherson A , Jones-Keeshig D , Pike I
Published: March 2011

Background

Injuries are the leading cause of death among First Nations in Canada from 1 to 44 years, Health Canada 2001. The Ontario First Nation population was 175 178 within 133 First Nation communities in 2008. Ontario First Nations identified Motor Vehicle Collisions, Violence including Suicide and Falls, as injury issues and recommended priorities in education, training and research. An Injury Prevention Initiative was established to address issues, implement priorities and develop an Ontario First Nation Injury Prevention Strategy and Action Plan. It is coordinated by the Chiefs in Ontario. Several projects were initiated to establish baseline information upon which to develop the Strategy and Action Plan. While data on Emergency Department visits and hospitalisations are available for all Ontarians, the data does not identify First Nation people, however, residential codes provided an opportunity to determine the rate of injuries for First Nation communities.

Objective

To calculate the frequency of ED visits for injury in Ontario First Nations communities, stratified by sex and intent.

Methods

Population-based data including all ED visits in Ontario were used based on Indian Reservation residential codes assigned by the Ontario Ministry of Health and Long-Term Care.

Results

The results showed that although injury rates were similar to the Ontario population, the incidence of intentional injury was 2.7 times higher among First Nations, and self-inflicted injuries were 4.6 times higher.

Conclusion

The findings validate that injuries are a serious issue in Ontario First Nations and the strategy and action plan needs to address violence and self-inflicted injuries.
Clinical legal medicine – community health outreach, results of a follow-up pan-European survey
Authors: Gage-Lindner N , Heinemann A , Seifert D , Siemer J , Pschel K
Published: March 2011

In a follow-up 2007/2008 to the first pan-European survey of legal medicine contributions to community health responses to gender violence, child and elderly abuse in 2003/2004, we investigated strategies legal medicine and forensic nursing are pursuing to provide violence victims low-threshold access to evaluation and documentation of injuries.

Methodology

A standardised written questionnaire submitted to n=227 medicolegal experts in 33 European countries. Country comparisons of several dimensions were conducted.

Results

In the 94 responses (41.4% response rate), 92% reported services in clinical legal medicine, 43% initiated in 1990 or later. 19% examine more than 1000 patients, 16% more than 100 children p.a. 94% investigate sexualised violence, 48% have paediatric-gynaecological expertise, 16% evaluate psychological abuse. Multi-professionality is increasing, teams include law, social work, clinical psyche and psychiatry, dentistry, gynaecology, paediatrics, forensic nursing. Forensic nursing is a growing expertise with 12% reported from the original 15 EU member states and Switzerland. Medicolegal competence centres in Germany provide highest rate of service outside office hours. Legal frameworks vary from inclusion in health/social welfare system to exclusive liaison with law enforcement and justice. Medicolegal evaluation is explicitly required or recommended in several countries.

Conclusions

Diversity in legal and financial parameters contributes to vast structural differences. Medicolegal approaches strengthen community health responses to violence. Mixing roles - medicolegal expert and health provider -creates ethical challenges. Funding remains a challenge. International know-how transfer and networking remain a priority.
Ontario first nations environmental scan on injuries and injury prevention
Authors: Cote-Meek S , Assinewe F , Jones-Keeshig D , Macpherson A
Published: March 2011

Background

Injuries are the leading cause of death among First Nations in Canada from 1 to 44 years, Health Canada 2001. The Ontario First Nation population was 175 178 within 133 First Nation communities in 2008. Ontario First Nations identified Motor Vehicle Collisions, Violence including Suicide and Falls, as injury issues and recommended priorities in education, training and research. An Injury Prevention Initiative was established to address issues, implement priorities and develop an Ontario First Nation Injury Prevention Strategy and Action Plan. It is coordinated by the Chiefs in Ontario. Several projects were initiated to inform the development of the Strategy and Action Plan.

Objective

The objective of the Ontario First Nations Environmental Scan on Injuries and Injury Prevention was to determine community-based injury issues, priorities, prevention initiatives and recommendations for injury prevention.

Methods

The method utilised was to distribute a key informant survey to each First Nation community in Ontario. Participants were asked to report the most frequent injury occurrences, to identify injury priorities, barriers and prevention initiatives including best practises.

Results

The results for children, identified falls and violence, for youth it was falls, violence and alcohol poisoning. Adults had motor vehicle collisions, violence, and alcohol poisoning, and elders reported falls, violence and alcohol poisoning. The lack of community involvement, education, training, research, and funding for injury prevention programs were identified broadly as recommendations.

Conclusion

First Nations communities understand the challenges facing their population, and want to take steps to reduce the burden of injury in their communities.
Ontario first nations child car restraint project evaluation
Authors: Cote-Meek S , Assinewe F , Jones-Keeshig D , Macpherson A
Published: March 2011

Background

Injuries are the leading cause of death among First Nations in Canada from 1 to 44 years, Health Canada 2001. The Ontario First Nation population was 175 178 within 133 First Nation communities in 2008. Ontario First Nations identified Motor Vehicle Collisions, Violence including Suicide and Falls, as injury issues and recommended priorities in education, training and research. An Injury Prevention Initiative was established to address issues, implement priorities and develop an Ontario First Nation Injury Prevention Strategy and Action Plan. It is coordinated by the Chiefs in Ontario. The issue of Motor vehicle collisions among Ontario First Nations included concerns about the reported low use of child car restraints. Few interventions to improve restraint use have been implemented and evaluated.

Objective

The objective of the Ontario First Nations Child Car Restraint Project was to promote child passenger safety and evaluate interventions in five communities.

Methods

Prior to community based child passenger safety interventions, participants were asked about their knowledge and behaviours related to the use of child car restraints. They then participated in interventions and answered the same questions after the interventions.

Results

The results reported knowledge increased significantly and a variation in the improvement by community, by gender and by education level. About half of the participants showed no improvement or had decreased scores.

Conclusion

Community-based interventions can improve knowledge and reported behaviour, but not all participants benefit equally. Interventions will need to be community based, culturally specific and targeted to population needs to improve success.
Could workplace accidents covered by social insurance workers compensation funds be used to calculate national indicators for surveillance of occupational injuries in France?
Authors: Brière J , Chevalier A , Feurprier M , Paboeuf F , Imbernon E
Published: March 2011

Background

Financial compensation for workplace accidents are paid by several funds in France. The advantage of these data is that each fund determines if the accident was work-related. But funds function independently and there have no efforts to make the data consistent or to centralise them. Another disadvantage is related to the kind of data, which is recorded for administrative purposes and not for epidemiologic surveillance.

Methods

The French Institute for Public Health Surveillance used individual information of occupational injuries of the three principal funds (84% of employees) for the year 2004. We defined essential information (especially the victim's sex and age, economic sector, occupation and cause of accident) and matched nomenclatures. We calculated national indicators for each fund and for all the funds: the number of occupational injuries, the incidence rate of cases of occupational injury, the proportion of serious and fatal injuries (according sex, age, economic sector).

Results

The number of occupational injuries for the three funds was 914 803 for men, 370 053 for women. The incidence rate reached 8.8 (per 100 employees) for men, 4.6 for women. The three leading sectors were construction (14.3), transport (10.9) and agriculture and food processing industry (10.4) for men, agriculture and food processing industry (7.0), education health and social action (6.8) and services to individuals (6.4) for women.

Conclusions

Calculation of national indicators for surveillance of occupational injuries seems possible. Recommendations will be proposed for the purpose of improving surveillance.
Trends of road traffic crashes in Sri Lanka
Authors: Jayatilleke A U , Jayatilleke A C
Published: March 2011

Introduction

Sri Lanka is a lower middle-income country in the South Asian Region which is facing a growing burden of road traffic crashes (RTCs). In Sri Lanka, RTCs lead to more than 2000 deaths and 14 000 casualties every year. We conducted this study to examine the trends of RTCs in Sri Lanka for the 30 year between 1977 and 2007.

Methods

We extracted the police reported RTCs between 1977 and 2007 from the statistics unit, police traffic headquarters, Sri Lanka. We calculated the crash and the death rates per 100 000 population and analysed the trends of RTCs during the 30 years. We plotted graphs to show the trend or the RTCs during this period.

Results

Between 1977 and 2003, all types of road traffic crashes increased markedly in Sri Lanka: total (194.8%), fatal (81.8%), grievous (257.9%), non-grievous (69.2%) and damage only (303.5%). However a reduction was observed in damage only (69.1), non-grievous (16.8%) and total (48.2%) crashes from 2003 to 2007. However, fatal crashes and grievous crashes increased by 11.0% and 24.5% respectively.

Conclusion

Since 2003, damage only, and non-grievous crashes decreased markedly. However such a reduction was not seen in more serious fatal and grievous crashes. In 2003, Sri Lankan insurance companies changed their insurance policies and introduced an on-the-spot payment scheme. No law amendment was introduced in 2003. Therefore the reduction of damage only, and non-grievous crashes could be due to the high under reporting of crashes, rather than an actual reduction.
Socioeconomic disparities in pedestrian injuries
Authors: Anderson C L , Vaca F E , Chakravarthy B
Published: March 2011

Pedestrian injuries are an important component of motor vehicle injuries, especially for children. We examined the association between pedestrian collisions and the social environment using data from a large suburban county in southern California.

Method

Pedestrian collisions were identified from the California State-wide Integrated Traffic Records System (SWITRS) (2000–2004). A Geographic Information System was used to map the location of pedestrian collisions and this was overlaid onto demographic and social characteristic data from the US Census (2000).

Results

4209 collisions were identified in 5 years of data. Exactly 4000 (95%) of these were geocoded to a specific location and mapped. The census tracts with the highest quartile of poverty had four times as many pedestrian collisions (relative to population) as the census tracts with the lowest quartile of poverty, and nine times as many pedestrian collisions involving children age 0–12 years (relative to their population). Other social variables, including education among adults and percent of adults who spoke another language at home and spoke English less than very well, were related to the frequency of pedestrian collisions. Population density was related to the frequency of pedestrian collisions only among children. None of these variables explained the association of poverty with the frequency of pedestrian injuries.

Conclusion

There is a substantial disparity in pedestrian injury risk by poverty in this county.
Rapid treatment of suicide states in the emergency department
Authors: Larkin G L , Beautrais A L , Lippmann M
Published: March 2011

Background

Suicidal behaviour is a pervasive and pressing public health burden. Emergency Departments (EDs) visits for mood disorders in general, and for major depression, suicidal ideation, and suicide attempts in particular, have increased in the last 15 years, showing no sign of declining. Intervening with effective treatments in the ED when suicidal patients are accessible could achieve a more rapid, effective and safe disposition. At present there is a dearth of effective ED treatments for acutely suicidal and depressed patients. A single sub-anaesthetic dose of IV ketamine can rapidly reduce depressive symptoms in treatment-resistant depressed (TRD) patients, with anti-depressant responses detected within 1–2 h postinfusion and maintained in a majority of patients for 1–7 days, without significant adverse side effects. To date, research has focused on the potential of ketamine to treat TRD.

Method

Pilot study to assess the feasibility of administering low-dose ketamine in the ED as a rapidly acting anti-depressant which alleviates the intensity of suicide ideation, as well as improving depressed mood.

Results

20 ED patients with a primary presenting complaint of suicide ideation or who have made a suicide attempt were administered single sub-anaesthetic dose of either ketamine (0.25 mg/kg IV bolus over 3 min). Ketamine rapidly reduced both suicide ideation and depressive symptoms.

Conclusions

These results suggest the exploratory research findings of a low dose of ketamine can be translated from TRD patients to the clinical setting of the ED for suicidal patients.
Willingness of volunteer paramedics to re-volunteer in a time of war
Authors: Jaffe E , Aviel E , Nave M , Knobler H , Aharonson-Daniel L
Published: March 2011

Background

Magen David Adom (MDA), Israel's national rescue organisation, used volunteers from northern Israel to reinforce emergency medical teams in the South during Operation Oferet Yezuka that affected only the southern part of the country. To ascertain the return of professional volunteers to additional reinforcement shifts in a time of war, the organisation needs to maintain satisfactory conditions. The goal of this study was to evaluate the factors influencing the willingness of reinforcing volunteers to return to another shift in a time of war.

Methods

A telephone survey of 99 out of 561 volunteers who came to reinforce the south in January 2009. The volunteers were asked about job characteristics, physical conditions, feeling of personal safety, and the correspondence between the volunteers' expectations and their job assignment.

Results

Physical conditions, reception and job assignment, as well as the number of events treated significantly influenced willingness to return to another shift. The number of events at the station and the level of satisfaction positively correlated with the willingness to return while the feeling of personal safety did not. The volunteers' anxiety was negatively correlated to the number of rockets that fell in the area of the station and the number of casualties treated.

Conclusions

The volunteers reported that they are willing to endanger their lives in order to repeatedly help during war. Appropriate reception and job assignment at the reinforcement station, reasonable staying conditions, and training and preparation for the reinforcement job will bring the volunteers back to another shift.
Identification of black spots for traffic injury in road intersections dependence of injury definition
Authors: Hansen D , Lauritsen J M
Published: March 2011

Introduction

In Denmark it is common practice that road administrations use black spot identification methods in planning. Assumed black spots are further reviewed based on traffic volume, modes of transportation and other considerations. For our region hospital based geo-located traffic injury information has been available for about 20 years and in the current project the aim was to investigate whether different definitions of black spots (hot spots) would point at different intersections for further scrutiny.

Methods

During the years 2002 to 2007 all 29 719 patient contacts due to traffic accidents treated at three hospitals for a region covering roughly 0.5 mio persons were recorded routinely and subsequently geo-coded to exact location. For 8191 injured persons the traffic accident occurred in one of 2157 road intersections. In total the county holds 56.994 intersections. Hot spots were defined as

The upper decile of injury generating intersections.

Intersections with at least one death or hospitalised patient.

The intersections covering the upper decile of injuries.

Results

The three definitions in combination identified 295 injury burdened intersections. Only three intersections were identified by all three definitions. All intersections fulfilling definition three were also included in definition one. Definition two covered 103 intersections, only 22 of these were identified by definition one.

Conclusion

The definition of Black spot has huge implications for identification of intersections considered as a black spot. GIS methods must take this into consideration.
Violence in the emergency department: a multicentre survey of nurses' perception
Authors: Ogundipe O K , Aladesanmi T , Adigun A I , Taiwo O J , Etonyeaku C A , Ojo O E , Obimakinde S O
Published: March 2011

Background

Emergency department (ED) violence is common and widespread. Research suggests that ED staff receive the most amount of verbal and physical abuse. Nurses bear the brunt of the violence. The violence is becoming increasingly common and lethal. Many institutions are still improperly prepared to deal with it.

Method

A questionnaire-based survey of the perception of violence among nurses working in six tertiary hospitals EDs across five states in the country was conducted.

Result

81 nurses were interviewed with a male to female ratio of 1:4. Most were right about the definition of violence. 88.6% have witnessed ED violence while 65.0% had been direct victims before. Nurses followed by doctors are the usual victims of the ED carried out mostly by visitors to the ED. Males are usually responsible for the violence, which occurred most usually in the evening. Weapons are not commonly utilised in our environment as only 15.8% of the nurses had been threatened with a weapon over a 1-year period. The main perceived reasons for violence are overcrowded emergency rooms, long waiting time and inadequate system of security. All the institutions are lacking in basic strategies for prevention. While most of the nurses are not satisfied with the EDs which are considered not safe, fewer would wish for redeployment to other departments.

Conclusion

There is need to make the EDs safer for all users, or else we might have to start wishing our ED users come back home safe.
Fall safety promotion in rural communities. input from injury data and community health workers in Twiserkan, Iran
Authors: Shokouhi M , Rezapur-Shahkolai F , Naghavi M , Laflamme L
Published: March 2011

Falls are one of important cause of injury morbidity. Knowledge is limited about fall-related injuries in low- and middle-income countries in general and in Iran in particular. This study aims to document the epidemiology of injuries among rural community and to determine how fall injury control and prevention are conceived by community health workers (known as Behvarzes), given the role that they are expected to play for local health and safety promotion. The study was a 6-month prospective injury data collection (from July 15th 2007 to January 15th 2008) that took place in one Iranian district and focused on severe injuries (leading to hospitalisation over 6 hours or death). Those were investigated by community health workers (Behvarzes) as a special assignment for them all (about 100). They used a pre-determined form (a logbook) for data collection on injuries of various causes, including falls. At the end of data collection Behvarzes were gathered in a number of group sessions to reflect about injury prevention measures and barriers in the community. The questionnaire they have to fill in was self-administered. A total of 23 severe fall injuries (two fatal) were reported during the follow-up period with an annual estimated incidence rate of 8/10 000 (95% CI 6 to 11). The incidence rate of severe falls was significantly higher among males than females (12/10 000 vs 3/10 000 person-years. Fall incidence rates was also higher among people 65 years and over (24/10 000 person-years). Severe falls led commonly to fractures and lower limb was the most common single body region. Most falls were from height, mainly from roof and tree, and about half were work-related. The injury analyses revealed that the Behvarzes often considered that the adoption of safe behaviour/practice could help preventing fall injuries (17 out of 23). Their post follow-up reflection on fall prevention indicates that education, provided by themselves could help prevent fall injuries (71 out of 87) and so could environmental improvement, people training and instruction, and cooperation and consultation by other actors in this field. Also the barriers or risk factors for fall injury prevention identified related mostly to human factors (for all 23 cases) followed by physical environmental factors. At the end of follow-up however, they identified several physical environmental factors (44 out of 87), followed by social and legal environment, and then, individual factors. The case-by-case injury analysis leads to the identification of human errors to a far greater extent than the post-follow up questionnaire session. Community health workers can provide a variety of suggestion for fall injury prevention and highlight potential barriers to their implementation among their catchment area.
Child and adolescent sexual abuse and violence in India: a review
Authors: Malhotra S
Published: March 2011

In recent years, there has been an increasing attention to sexual coercive experiences of young people in developing countries, including India. Research done in this newer area is generating new evidences that call for more specific interventions. It is imperative that the findings coming from qualitative and quantitative research should be assimilated to present the perspectives in this context for a diverse group encompassing married and unmarried young people aged. Thus a review was undertaken to determine prevalence of different non-consensual sexual experiences and the related correlates found out through multivariate analysis. A thorough search was done using key search engines, manual search of grey literature, websites, cross references of articles searched in English language. Sexual abuse and violence is observed in both Indian boys and girls in their early years of life. Both community and facility based studies have shown traumatic and painful experiences of young people. 13%–32% boys and 12%–42% girls have reported unwanted touching, 4%–15% boys and 3% of girls reported forced physical relationship. Evidence is also available to suggest vulnerability for street children for facing such adverse experiences. Older children, neighbours and strangers are most common perpetrators reported. Having a friend of opposite gender, poor academic performance, poor mental and physical health, greater substance abuse, poorer parental relationships are associated factors for undergoing coercive behaviour. Urban rural differences also exist. The findings underscore the need to develop programs that enable children and adolescents to prevent and cope with non-consensual sexual experiences.
Economic development and road traffic fatalities in two neighbouring African nations
Authors: Wiebe D J , Branas C C
Published: March 2011

Background

Botswana's rapidly growing economy has brought infrastructure advances including roadway development, more vehicles, and an escalating road traffic fatality rate. We tested the hypothesis that the association between annual gross domestic product (GDP) increases and road traffic fatality increases was causal. Zambia, which neighbours Botswana but has not experienced rapid growth, was used for comparison.

Methods

Annual time series of social and economic indicators and road traffic fatalities in Botswana and Zambia for 1981–2008 from World Bank and World Health Organization data were analysed using vector autoregressive and Granger causality tests.

Results

Botswana dramatically outpaced Zambia between 1981 and 2008 in economic indicators including GDP per capita (9% vs –1% mean annual change) and GINI per capita (18% vs 2% mean annual change). Vehicles per 1000 capita increased 36% in Zambia but 800% in Botswana (18 in 1990, 156 in 2007). Between 1981 and 2005 the road traffic fatality rate increased 4.7 fold in Zambia and 9.2 fold in Botswana. Annual road traffic fatality rates in Botswana were associated with GDP (billions) 4 years earlier (b=9.9, p<0.01). Similarly, despite being lower, annual road traffic fatality rates in Zambia were associated with GDP 3 years earlier (b=0.2, p<0.05). Granger tests suggested that in both countries, directionality went from GDP to fatalities and not vice versa.

Conclusion

The economic development that occurred in Botswana and Zambia produced proportionate road traffic fatality increases. Road safety improvements should be concomitant with economic development.
SMARTRISK's theory of change for prevention of injury among Canadian youth
Authors: Groff P R , Marshall S , Baker B
Published: March 2011

The model employed by SMARTRISK to develop the Theory of Change for Youth was adapted from one proposed by the Aspen Institute Roundtable on Social Change. It is recognised as a best practice in the art of theory construction. The process begins with identifying the end goal an organisation wishes to achieve, the ultimate intended outcome(s) of any strategies. Next, a process of backwards mapping is undertaken whereby any preconditions (intermediate and shorter term outcomes) to arrive at the final goal are noted. Throughout this process, each outcome is assessed to determine whether it will necessarily lead to the next outcome in the model, or whether a planned intervention by the organisation is necessary. In addition, any underlying assumptions about objectives or the links between them are made explicit. The authors will be presenting the Theory of Change for Prevention of Injury among Canadian Youth, and illustrating specific application of the Theory of Change with evaluated examples of SMARTRISK's injury prevention programming for youth.
Carbon monoxide poisoning surveillance: a French Environmental & Health surveillance system integrated in preventive policies
Authors: Verrier A , Daoudi J , Gourier-Frry C , Salines G
Published: March 2011

In France, carbon monoxide (CO) poisoning strikes over 5000 people who have to be managed in emergency conditions. In order to improve our knowledge on CO poisoning circumstances, a specific surveillance system has been set up. Its main objective is to provide epidemiological description of poisoning in order to improve preventive messages and rules.

Methods

In France, governmental procedures impose that each CO poisoning case has to be reported to poison control centres or public health services. A technical investigation is immediately conducted to identify causes of poisoning. A medical investigation is also set up to describe clinical symptoms, medical management and severity. Since there are no specific clinic symptoms of CO poisoning, an epidemiological case definition was built, combining both environmental and medical criteria (clinical symptoms, impregnation estimation, atmospheric measurements, and technological signs).

Results

About 1300 CO poisoning incidents involving 4000 exposed persons were yearly declared. 85% of those were domestic unintentional poisoning, half of which concerned home owners and were caused by gas furnaces with favouring conditions like voluntarily obstructed ventilation. Public health preventive messages focused on good ventilation and annual check of gas furnaces. During winter power outages, outbreaks were due to misuse of generators or portable heating devices. Preventive messages then focused on the right use of these devices.

Conclusions

This surveillance system has improved our knowledge about CO poisoning circumstances. A dual strategy of preventive messages and rules has been set up to transform public health knowledge into action.
Burn out and craft emergency
Authors: Marien P , Auvert L , Porras J , Michel G
Published: March 2011

Burnout (BO) is an international phenomenon studied. It is very important in the sectors of Health, Education and Defence but remains largely unexplored among firefighters, policemen (Parent-Thirion et al, 2005; Lavillunires et al. 2007; Lourel et al., 2008). Most studies have tried to apprehend the BO or through individual characteristics or through the environmental requirements but neglecting the relationship that both could maintain.

Objective

To investigate predictors of BO among French fire fighters, policeman and emergency workers.

Method

100 fire fighters, 100 emergency workers will answer to the Temperamental and Character Inventory (TCI-56; Rigozzi and Rossier, 2005), to Job Stress Survey adapted to urgency workers (JSS-F, Marien, Auvert and Michel, 2009), to Coping Stress Inventory (CISS; Rolland et al., 1994); to the Maslach Burnout Inventory (MBI; Dion and Teissier, 1994).

Preliminary Results

BO is caused by the interaction between occupational stress and coping. In this case, personality moderate this relationship.

Discussion

These findings emphasise the importance of differentiating these individuals according to their job requirements vary by rank and focus on the importance of subjective dimension in this syndrome. They bring to light the importance of interactional process between individuals characteristics and environmental constraints. This can orient some intervention approaches that can be access on the motivational aspect. In this case, the job could be for a redefinition of goals but also on expanding the flexibility and skills to both business and personal given the opportunity to respond optimally to environmental constraints.
Road traffic injury surveillance system using combined data, Peru-2007
Authors: Medina Y R , Espitia-Hardeman V , Dellinger A , Loaiza M , Bolarte J , Leyva R , Cisneros G
Published: March 2011

Introduccin

En el Per, los accidentes de trnsito son uno de los ms importantes problemas de salud pblica. El objetivo de este estudio fue describir las no mortales de trfico por carretera de la lesin de vigilancia establecido a nivel nacional, utilizando los datos combinados. Mtodo: Este es un hospital de un sistema basado en prctica en 2007 en unidades centinela (instituciones de salud) en el pas. La informacin se recoge a partir de tres diferentes fuentes de datos: registros de los hospitales, los informes policiales, y los datos de seguros de vehculos. Las lesiones no mortales de trfico por carretera que asistieron por primera vez en los departamentos de emergencia estn incluidos en el sistema. La informacin es analizada peridicamente y presentados en reuniones con los tomadores de decisiones, y difundido a los participantes en el sistema. Resultados: Despus de dos aos de los resultados de la recopilacin de datos indica que la mayora de los casos se asisti a los peatones y cuatro ocupantes de los vehculos de ruedas. El mayor porcentaje de los peatones se encuentra en Cajamarca (56,4%), un estado en el noroeste del pas. Sin embargo, en algunos Estados de la regin amaznica (Loreto, San Martn y Ucayali), motociclistas y pasajeros de los vehculos de motor representaron un importante porcentaje de los casos. La distribucin por grupo de edad y sexo de la persona lesionada muestra un nmero mayor de hombres de 20 a 34 aos, con un nmero importante en el grupo de 5-9 aos de edad. Conclusiones: Algunos de los problemas del sistema son la sostenibilidad de las unidades participantes centinela y la expansin al resto del pas. El mayor desafo consiste en identificar intervenciones apropiadas de prevencin sobre la base de estos datos.
Demonstrating your programs value through success stories: CDC's new internet-based tool
Authors: Mitchko J , Holmes W
Published: March 2011

Documenting successful injury prevention and response interventions and their impact in an efficient, compelling way, has not been possible-until now. At CDC's National Center for Injury Prevention and Control, one of our roles is to improve public health practice and foster translation of research into practice. In this role, NCIPC is currently developing an Internet-based portal to enable injury prevention and response practitioners to develop and disseminate success stories. We have learned that to create an effective tool, it must be designed “easy to find, easy to use”. Once a user enters the portal through the CDC/NCIPC website, they can create their own story account by setting up a username and password. While there, users will be able to develop, edit and save their stories to their own computer. Users can access a resource page with current data and content related to the topic they are reporting on. The result will be a presentable, downloadable document available in both PDF and Word versions. The story can be saved on the user's desktop and shared with others. NCIPC funding recipients will also be able to submit their stories into CDC clearance for permanent archive in an on-line story database. The success stories portal provides an inexpensive method of broadly disseminating concrete and accurate summaries of effective interventions. The success stories may guide future global, national, state and local efforts to prevent injury more effectively. A demonstration of this new CDC tool will be presented.
Burn injury and the impact on global health
Authors: Ebel B E , Nelp T , Klein M B , Gibran N , Rivara F P
Published: March 2011

Background

Burn injury is a serious and under-recognized global public health problem. Citizens of low and middle income countries (LMIC) bear the largest burden, accounting for 95% of fatal fire-related burns. Measuring the impact of burn injury may facilitate a rational approach to prevention and treatment.

Objective

Review and summarise global literature on fatal and disabling burn injury in LMIC.

Methods

We conducted a literature review of Medline and EMBASE libraries for articles on burn or fire injury, published between 1980 and 2009. We limited reviewed articles to those with a defined study population. Using these criteria, 111 articles were identified and abstracted.

Results

Countries reporting burn data included representation from all WHO global regions. Twenty-three countries reported on burn incidence from regional or national population-based surveys. Burn injury rates ranged from 26 to 411 per 100 000 people. Among younger children, males had a higher burn incidence than females. However the burn prevalence among females rises with exposure to meal preparation, and in most countries females are more likely than males to sustain burn injuries into early/middle adulthood. Ninety countries reported data on burn fatalities or hospitalisation. Median TBSA for hospitalised patients was 20.1% (7% to 54%). Frequent causes were scald >flame >(electricity, chemical). Flame burns are the leading cause of death.

Conclusions

Burn injury is an important cause of injury in LMIC. Women face particular risks, likely related to exposure while cooking.
Primary injury prevention and mortality from motor vehicle crashes among children and adolescents in the USA: from safety behaviours to healthy environments
Authors: Pinet-Peralta L M
Published: March 2011

Every year, over 1800 children die and more than 200 000 are injured in motor-vehicle crashes in the USA, increasing the economic burden associated with medical care/rehabilitation andyears of potential life lost. The majority of deaths and injuries are preventable and involve improper use of restraint devices and alcohol, high speeds and built environments that promote vehicle performance. Studies evaluating the impact of environmental modifications on childhood fatal motor vehicle injuries have not been executed in the USA at the national level. The objective of this research is to evaluate the effects that primary prevention policies have had on reducing mortality from motor-vehicle crashes among children and adolescents in the USA.

This is a retrospective study based on 1997–2005 data from the FARS, the IIHS, the US Census, US Presidential elections and US Labour Statistics using negative binomial regression with fixed-effects. I expect to find significant reductions in the proportion of deaths among states with primary enforcement of restraint laws, driver education programs and checkpoints compared with states with secondary/inexistent laws. I also expect to find mortality reductions among states with speed reduction and traffic calming measures compared with states without such measures.

This study evaluates the effects of primary injury prevention policies on fatal injuries from motor vehicle crashes among children and adolescents at the national level using a longitudinal perspective. Results may be useful to policy-makers and public health practitioners involved in injury prevention and public health.
Counterfeit and non-compliant electrical products
Authors: Allen M , Curtler S
Published: March 2011

The market in counterfeit watches, designer clothes, CDs and DVDs has enjoyed widespread publicity. But the market in counterfeit electrical installation products is far more serious because it may involve risk to life. Some products, for example fuses and circuit-breakers, are intended to provide electrical protection, so must function correctly. Others like electrical appliances, wiring accessories, switches, cables and control gear perform a more functional role but safety in use is crucial, along with reliability and performance. Counterfeit electrical products are almost always substandard, posing a risk of harm to consumers and installers alike. Counterfeiters are able to copy the external appearance of an electrical product and its packaging fairly well, but the internal design, materials or chemical composition is substantially different from the genuine product and can pose serious dangers. The facts annually, an estimated 30m worth of counterfeit electrical products reach the UK. It is believed that more than 95% of counterfeit electrical installation products originate from China. Up to 15% of world trade is thought to be in counterfeit goods and in some cases this may be used to help finance other criminal activity. As an industry, we need to consider how we can work collectively to address areas of specific concern, in particular the growing trade of counterfeit and non-compliant goods over the Internet and the validity of CE marking when applied to electrical products. It is also important for industry to communicate consistent messaging on these issues.
Pattern of burns at a paediatric hospital in Nairobi
Authors: Mutiso V M , Khainga S
Published: March 2011

Introduction

Burns are a common cause of morbidity and mortality in children and are largely preventable.

Objective

To determine the patterns of burns among admissions at a paediatric hospital in Nairobi.

Methodology

This was by retrospective survey.

Results

The age range of the study population was from birth to above 20 years. Ages 1–4 comprised 52.5% and 5–9 years was 27.9% of all admissions respectively. Burns comprised 20.2% of all admissions (202 of 1001) and was the second commonest reason for admission after falls. It was also the second commonest diagnosis with the most common being fractures. The majority of children with burns had burns at multiple sites. The upper limbs were the commonest site with about 5% followed by chest, abdomen and thorax with 35.8%. The neck comprised 23.9%. As mentioned earlier, many were multiple burns and thus had burns in more than one region or site. The gluteal and genital area comprised 8.2% and the least burns was proplited fossa with 1.9%. The most common percentage burns was 5 9% with 33.3%. 10–14% comprised 23.3% while the third commonest percentage burns was below 5%. Only 0.2% received burns above 30% and above.

Discussion

Burns are a common and significant cause of admission following injury in children.

Conclusion

Urgent action needs to be taken to prevent burns, threat to life and significantly impact on quality of life among survivors in terms of cosmetic deformities with attendant psychosocial impact and physical deformities that impact ability.