bluuebunny/crossref_metadata_2025 huggingface dataset:
Does the current New Zealand case definition of serious non-fatal injury miss a material number of serious injury cases?
Authors: Cryer C , Gulliver P , Langley J , Davie G , Samaranayaka A
Published: March 2011

Background

Similar to other countries, in New Zealand (NZ) a case of non-fatal injury is captured if the principal diagnosis (PDx) on the hospital discharge record is coded to the injury chapter of International Classification of Diseases (ICD). There has been recent debate in NZ about whether this operational definition captures all cases that are of interest to injury prevention practitioners and policy makers. Research question: Does the case definition of serious non-fatal injury, used in the specifications of the NZ serious injury indicators, miss a material number of serious injury cases of interest?

Methods

Empirical methods were used to investigate an alternative definition of serious non-fatal injury. The alternative definition involved relaxing the criteria for PDx to be within the ICD injury chapter, provided there exists an injury diagnosis on the hospital discharge record, and the severity of the injuries recorded on the record exceed a pre-existing agreed threshold. Results, including case scenarios, were presented to a stakeholder group, where agreement on the most appropriate case definition was sought.

Results

Relaxing the requirement for the PDx to be an injury resulted in 7% more serious non-fatal injury cases. The largest percentage increase in cases was found for self-harm, which showed a 17% increase.

Conclusion

The current NZ case definition potentially misses a material number of serious non-fatal injury cases of interest to the stakeholder community. There is evidence, and agreement with stakeholders, to support the adoption of the more inclusive case definition.
Injury deaths: are we missing a material number of cases?
Authors: Cryer C , Gulliver P , Samaranayaka A , Davie G , Langley J
Published: March 2011

Background

As in other countries, many of the New Zealand (NZ) national fatal injury indicators are derived from the underlying cause of death (UCoD) as captured in the national Mortality Collection (MC). Recent work in NZ, similar to work in Sweden and Australia, has exposed apparent contradictions between hospital data and the MC: for many of the injury cases that died in hospital, the UCoD recorded on the MC was a medical cause.

Aim

To investigate the current and alternative methods of identifying injury deaths.

Methods

NZ hospital discharges, with a principal diagnosis (PDx) of injury, were linked to the MC. Gross mismatches between PDx and the UCoD were described for people injured in the period 2000–2004, by selected variables (eg, age, sex, external cause, intent, PDx). Taking cognisance of (1) WHO coding rules for mortality, (2) definitions of injury death used by injury epidemiologists and (3) identified mismatches, alternative definitions of injury death were proposed.

Results

Of the 1713 people discharged from hospital with an injury PDx who died within 7 days of their injury, 39% did not have an injury UCoD. Of the 5900 who died within 3 months of their injury, the corresponding figure was 66%. There was variation in the percentage with non-injury UCoD by age, sex, external cause, intent and PDx.

Conclusion

Alternative theoretical and operational definitions of injury death are clearly needed. Definitions that capture relevant cases for epidemiologists, prevention practitioners and policy makers have been proposed.
A comprehensive approach for reducing the incidence of domestic burns in rural upper Egypt
Authors: El-Otiefy M , Zakhary M M
Published: March 2011

Project Burn Prevention, an educational program about burn prevention and safety, was implemented in Rural Upper from January 2008 through November 2009. The program consisted of two components: a school-initiated intervention (puppet theatre for primary school children and awareness seminars for secondary school students), and a community-initiated intervention (home visits for housewives, women home based seminars and community awareness seminars). Burn-survivors are the main implementers of the components tools throughout their rehabilitation. Local fire-fighters department participation helps revising and approving the messages and the content of the awareness program. The messages were designed based on local context as well as on real accidents. Estimates of burn incidence and the prevalent practices for the first aid measures within the community were made on the whole community for a 1-year period before the program, and the 12 months after the program. Analysis of burn incidence during and after the interventions showed that the program intervention have brought a reduction in the rate of burn injuries as well as a significant improvement of the first aid measures for burns inside the house.
Unintentional fires caused by products that focus sunlight
Authors: Altkorn B , Emerson G , Chen X , Milkovich S , Stool D
Published: March 2011

Unintentional Fires Caused by Products that Focus Sunlight Objectives The ability of myriad and sundry transparent and reflective objects to set fires by focusing sunlight has likely known since before the dawn of recorded history and was cited nearly 2500 years ago by Aristophanes. Yet modern generations greet this phenomenon with awe and bewilderment. Over the past decade product recalls, news stories and lawsuits have focused concern on domestic and wildfires set by such seemingly diverse objects as balls, garden ornaments, water bottles, dog bowls and lucky charms. No published safety standards or guidelines so much as mention this rara avis. We address it from historical and engineering perspectives and provide guidance on its assessment. Materials and Methods Recalled and historical products are reviewed. Fire prevention standards and literature involving radiant ignition are examined, as are terrestrial solar irradiance data. Relevant information from imaging and non-imaging optics is cited. Heat transfer variations between large and small irradiated areas are explained. Results of experiments with consumer products are presented.

Results

Methods of recognising, assessing and minimising hazards of accidental fires from sunlight focused by transparent and reflected objects are discussed.

Discussion

Understanding the radiometric characteristics of sunlight and focusing properties of transparent and reflective consumer products enables product designers to avoid unintentional fires.
Assessment and prevention of infant sleep environment hazards
Authors: Stool D , Emerson G , Reilly J , Fox W , Shaffer T
Published: March 2011

Assessment and prevention of infant sleep environment hazards. Many children sleep in consumer product sleep environments, some intended for this purpose, some that are not. Infants are not just tiny adults. Greater airway compliance, shallower respiration, and cartilaginous bony structures increase the potential for airway compromise. Caregivers have a high degree of expectation that all of these consumer products are safe for their infants as sleep environments, therefore vigilance is generally low. Risk of injury equals hazard multiplied by exposure. To manage this risk hazard must be pushed as close as possible to zero. Intertek has conducted research in conjunction with leading paediatric pulmonologists and respiratory physiologists from the University of Pennsylvania and the Alfred I DuPont Institute to develop an artificial respiratory system and infant interface equipped with pressure sensors that allow products to be evaluated for their potential to cause a variety of airway obstruction injuries. There are a wide variety of design strategies to reduce the hazard of strangulation in infant sleep environments. Generally, if designers are made aware of the potential hazard they can devise a large number of effective solutions. Changes to public policy regarding consumer product safety are being promoted at both the state and federal level. These changes are likely to require increasingly stringent evaluation of products, especially those that are intended to be in contact with infants. Consumers who are caregivers for infants are intently motivated to be certain that the products that they buy have the lowest possible level of hazard.
Safe product design (Saf-D-Pro) certification scheme
Authors: Rider G , Inman M , Nielsen E , Reilly J , Vincenten J , Hakkinen P , Reiss R , Easton R , Chen X , Emerson G
Published: March 2011

Consumer product safety is vital in our daily lives. Driven by recent recalls, regulatory authorities around the globe are strengthening its requirements and enforcement in order to regain confidence among consumers. Historically, approximately two-thirds of recalls were the result of design defects. Robust design appraisal as a remedy for the root causes of product recalls has received significant attention. Nonetheless, there has been a lack of governance and standardisation for design appraisals. As a result, RABQSA International, a recognised leader in designing, developing, and delivering accredited personnel and training certification services, has moved forward with an initiative to develop a competency-based personnel certification program for Consumer Product Design Safety Assessment (CPDSA). An international multi-stakeholder steering committee was formed to develop a personnel certification scheme for design appraisers of consumer products through incorporating the best techniques and practices available. Six elements of competency were identified: (1) market place product entry requirements; (2) data analysis; (3) foreseeable use; (4) Engineering, chemical, and (micro)biological analyses; (5) human factors; (6) product characteristics. A skill examination was developed based on these six elements to assess the practical competency of applicants. This initiative paves the way for future development of a certification scheme for consumer product risk analysts.
Road accident causes among truck drivers: a multicentric study
Authors: Orsi C , Morandi A , Marinoni A
Published: March 2011

Few studies are available regarding accidents involving trucks and even less is known about the cause. To fill in this lack of knowledge, we performed an analysis in order to identify the main causes of accidents involving trucks, using data obtained form European Truck Accident Causation a research conducted across France, Germany, Hungary, Italy, Slovenia, Spain and The Netherlands. Accidents involving at least one truck and one injured person have been investigated. Data collection started on April 2004 and finished on September 2006. Accidents were collected from sample areas representative of the national truck accident situation. The first investigation was on the spot of the accident as quickly as possible; if necessary, investigators investigated again the accident. Parameters on infrastructure, vehicles and people involved were evaluated. In total, 624 accidents have been investigated. The majority of truck drivers was professional drivers (97.0%) involved in the accident while working (86.8%). In 91.7% of cases the main accident cause is linked to human factors. The main cause varied according to the accident configuration. In accidents at intersection was the failure to observe road rules; in accidents in queue or during an overtaking manoeuvre was inattention; for accidents due to a lane departure were non-adapted speed and improper manoeuvre when turning; for single-vehicle accidents was overfatigue/falling asleep. This information can be used to give guidance to policy and decision makers for future action which can contribute to the improvement of road and occupational safety.
Effectiveness of a data sharing strategy for violence prevention: a quasi-experimental study
Authors: Shepherd J P , Brennan I R , Florence C , Simon T R
Published: March 2011

Background

Violence is the fifth most common cause of death worldwide among 15–29 year olds; in 2004 there were more than 600 000 deaths worldwide caused by violence.

Methods

Prompted by discoveries that a great deal of violence which results in emergency care is not ascertained by the police, a health service, police and local authority partnership was established in Cardiff to share emergency service data relevant to targeted prevention. Impact was assessed over 50 months using police records (more serious and less serious woundings, common assault), violence-related emergency department attendances in Cardiff and in Home Office designated most similar comparison cities. Socioeconomic conditions and adoption of a national crime recording standard in these cities were controlled for.

Findings

The programme was associated with a substantial and significant reduction in wounding (by approximately 100 per month by month 50; 95% CI 940 to 1070) and in emergency department attendances (by approximately 30 per month; 95% CI 235 to 375) and with a significant increase in common assaults (by approximately 35 per month (95% CI 287 to 410). Interpretation This programme is associated with reduced violence both from a police and emergency department perspective. The principal mechanism is likely to be more frequent and earlier police intervention consequent upon better targeted policing than is achievable using police data alone.
The Mortuary as a source of injury data: progress towards a mortuary data guideline for fatal injury surveillance
Authors: Grills N , Ozanne-Smith J , Bartolomeos K
Published: March 2011

Background

Injury is a substantial and preventable public health problem accounting for 10% of deaths worldwide, of which 90% are estimated to occur in low and middle income countries (LMICs). To help bridge the obstacle of inadequate data in LMICs a simple cost effective system for mortuary surveillance of fatal injuries is being developed in consultation with the WHO. This will inform, direct and monitor injury prevention interventions and policies in LMICs. There are many challenges to the establishment of an international guideline for mortuary data surveillance and this article seeks to outline the process, challenges and progress.

Methodology

This article uses CDCs attributes of a successful surveillance system to characterise barriers anticipated in guideline development and discuss the way forward.

Conclusions

The development of a mortuary data guideline has proceeded and overcome various barriers. The consultative process generated feedback from key stakeholders including forensic pathologists, Ministry of Health officials and injury prevention experts. An International Advisory Group was also convened. These steps have assisted adjustment of the proposed guideline to maximise flexibility, acceptability and stability; while minimising resource implications. Representativeness and the securing of government support perhaps remain the most significant challenges.

Implications

Consultation with the advisory group and the wider stakeholders has been effective in developing a widely acceptable, user-friendly, low resource data form to gather useful data. Further strategies to overcome barriers will be developed over the course of the pilot study and this needs to be done in consultation the advisory group and stakeholders.
Implementation challenges facing hospital-based surveillance systems in Africa: lessons learned from IPPNWs Multinational Injury Surveillance System (MISSPP) and South Africa's National Non-fatal Injury Surveillance System (NANFISS) pilot projects
Authors: Matzopoulos R , Zavala D , Mtonga R , Valenti M
Published: March 2011

Introduction

Quality data are important for health resource allocation and the design, implementation and evaluation of injury prevention programmes and policies. Such data are seldom available in resource poor settings. Although there have been successful attempts to systematically collect mortality data, the introduction and sustainability of hospital-based injury surveillance has been more challenging.

Materials and methods

This study describes the implementation of two hospital-based injury surveillance pilots in Africa by International Physicians for the Prevention of Nuclear War, and a South African research consortium. It draws on the findings of process evaluations conducted during implementation. The examples of Zambias Lusaka University Hospital and South Africa's GF Jooste Hospital in Cape Town reveal similar recurrent themes.

Results

The utility of the injury data was apparent to various stakeholder groups, and although both projects met with initial success, neither was sustainable. Key weaknesses invariably related to a lack of institutionalisation and local investment. For example, there was no centralised oversight to coordinate the projects in the absence of the implementing research agencies, new staff were not adequately trained in data collection and, as there was no formal inclusion in hospital protocols, data collection was regarded as research and conducted ad hoc.

Conclusion

The findings have implications for future attempts to introduce routine injury surveillance in resource poor settings, and indicate a role for multilateral agencies in developing and promoting implementation guidelines for adoption at a national level, as well as investment by health authorities in quality data collection, analysis and reporting.
Emergency and trauma care quality in Sindh province, Pakistan: a comprehensive assessment
Authors: Razzak J A , Khan U R , Heller D , Baqir S M
Published: March 2011

Background

Trauma and other medical emergencies are a substantial component of the burden of preventable morbidity and mortality in developing countries. We evaluate the availability of emergency medical equipments/ medicines across four districts Methods: This is a cross sectional study. We selected 93 out of 121 known public health facilities by stratified random sampling, These included a total of 67 Basic Health Units (BHUs), 14 rural Health Centers (RHCs), 12 public referral-level hospitals We have selected 12 private tertiary care hospitals by convenience sampling. The instrument for assessment of trauma and emergency equipment was derived directly from the WHO Guidelines for Essential Trauma Care.

Results

Overall, 105 healthcare facilities were surveyed. Majority of respondents (93.4%) reported no one in their facility had received formal training in emergency or trauma care. Many inexpensive and vital supplies were widely lacking, such as epinephrine (found in 30% of basic health unit facilities) and slings and splints (found in 18% of these facilities). Only one of 67 BHU facilities surveyed had an oral or nasal airway, compared to 11 of 12 private hospitals. Acetylsalicylic acid (aspirin) was available in only 67% of public referral hospitals and private hospitals; and an even smaller proportion of RHCs and BHU facilities. Fluid solutions, by contrast, were almost universally available across all levels of care.

Conclusion

Wider distribution of a handful of low-cost supplies could substantially decrease morbidity and mortality from emergencies and trauma in the province.
Impact of a school-based helmet promotion program on knowledge, attitudes and practices of eligible adolescent drivers
Authors: Germeni E , Lionis C , Kalampoki V , Davou B , Belechri M , Petridou E
Published: March 2011

Objective

School environment has been often identified as a prosperous venue for injury prevention and safety promotion. This study sought to investigate the impact of a school-based helmet promotion program on knowledge, attitudes and practices of eligible adolescent drivers.

Methods

A cluster randomised controlled trial was implemented, with schools as the unit of randomisation. Four public, four private and four vocational high-schools situated in Attica, Greece, were sorted by type and randomly assigned to receive a one-month intervention, based on the key concepts of the Health Belief Model, or serve as controls. Self-report data were collected at baseline from 741 second grade students (∼16 years) and immediately after program completion.

Results

After program completion, helmet-related knowledge was significantly improved for all intervention students. The adjusted mean changes from baseline to post-test were: 1.71 for students attending public schools (p=0.0001); 2.31 for students attending private schools (p=0.0001); and 1.31 for students attending vocational schools (p=0.0001). Notwithstanding the greatest increase observed in private high-school students, the intervention had no impact on their attitudes and practices. Of note, individuals enrolled in private education had the lowest frequency of two-wheel motorised vehicle use, with 18.2% reporting frequent use, as contrasted to 38.6% in public schools and 61.1% in vocational.

Conclusions

The intervention was successful in increasing students knowledge about helmet use. Nevertheless, its impact on helmet-related attitudes and practices of participants appeared to vary across different school types.
Peculiarity of road traffic in Azerbaijan
Authors: Talishinskiy R
Published: March 2011

There is a global problem associated with crisis in road safety and transport.

My country has the same symptoms of global disease. There are few local programs of different departments. Statistic, available data and analysis of situation demonstrated increase of mortality and injuries as result of traffic crushes. There were more than 1000 dead in traffic accidents in Azerbaijan each year.

It is fact is that transport is often considered economically more important that health/environment issues in some kind of countries. Also the interest of pedestrians and cyclists are generally less taken in consideration against interest of car drivers and bus traffic.

Crash epidemic culminate critical level. It is determinate by increasing of population, number of vehicles, imperfection of traffic infrastructure, human factor etc. Human factor includes drink-driving, ignoring of usage of seat-belt and the sense of fatalism.

Many specialists consider that intersections are the transportation system element most susceptible to traffic crashes and injuries. Crashes occur at intersections, and percentage is higher for urban areas.

Decision of problem is local. There are a few project of improvement of road infrastructure. Authority tries to create some traffic strategy program. Realisation of this strategy will request well coordinated work of different sectors and departments.

My country successfully participated in WHO project Global Status Report on Road Safety (GSRRS) in 2008. GSRRS helped us to develop a tool that will help my country access situation on traffic sphere. Realisation of GSRRS really stimulates road safety activities.
Epidemiology of road traffic injuries: interest of health surveys
Authors: Senterre C , Dramaix M , Leveque A
Published: March 2011

The Belgian situation in road safety is one of the poorer in European Union. Moreover, the barometers of road safety show, between 2006 and 2007, increases of 4.6% in accidents and 4.3% of death. Beside this increase in mortality, they contribute to an important part of morbidity. The objective of this study is to describe the epidemiology of injuries reported in health surveys (with a focus on road injuries). The data came from the Health Survey 1997, 2001 and 2004 conducted by the Scientific Institute of Public Health with Belgians aged 15 and more. The frequency of all causes accidents (who required a medical consultation) increased from 4.7% in 1997 to 8.0% in 2004. Among them, accidents on public roads increased by 12.8% in 1997 to 24.0% in 2004. In 2004, the frequency of accidents is found highest among 15 to 24 years (28.7%), 25–44 years and 65 years and over (29.2% in these two categories). The lesions most commonly found are fractures (31.0%), contusions (31.0%) and wounds (21.0%). We can conclude that descriptive population studies provide valuable information which should provide additional data to those given by police source. The liking with hospital databases allows greater precision on the severity and the evolution of trauma. This step will have a more global view on the importance of road trauma
Suicide prevention in Belgium: from scientific field to politics
Authors: Senterre C , Dramaix M , Leveque A
Published: March 2011

In Belgium, suicide is still a public health problem. Until recently, there was no real public policy of prevention. However, it has been demonstrated that for injury prevention, actors must have access to relevant and structured informations in order to choose the most efficient actions to (try to) solve the problem. The objective of our research was to establish a political document including propositions for priority actions that could help decision making. This work is based on informations from scientific studies and from field experiences. The first step was the elaboration of a conceptual framework of the suicidal process. At the same time, a register of active field workers has been established in order to make a link between their actions and the conceptual framework. This step led us to identify the strengths and weaknesses of prevention in our country. We noted that many positive actions were conducted but there was usually no link between them nor between actors, neither between the different levels of government. Our results have been sent to the Belgian parliament and a resolution aiming at defining suicide as a public health priority was adopted. This resolution also set the necessity of the elaboration of a global plan to coordinate the actions of the different actors. The approach followed as well as the interactions between deputies and researchers will be described
Youth sex offenders: descriptive survey from the population takes in charge by a specialised team
Authors: Senterre C , Dramaix M , Leveque A
Published: March 2011

Sexual criminality is a well-known problem but the problem of youth sex offender is poorly documented, especially in Belgium. Created in 2001, the team Groupados, from the SOS Enfants centre, is a specialised team which takes in charge this type of youngsters. In order to know better this population, the team had created a data collection form. Between 2006 and 2008, an action research was done, on request of the Ministery of Youth Assistance, in close collaboration with the Health Psychology unit and the Department of Biostatistics of the ULB School of Public Health. One of the main objectives is to study the characteristics of youngsters taken in charge by Groupados; and another is to improve the efficiency of the tool (from paper version to data entry program). The purpose of this paper is to present the major results of the analyses of the data collected in 2005 and 2006 (n=82). Half of the youngsters have abused more than one victim and in a third of the cases, victims are boys. Violence is also used in two thirds of abuse cases. The major facts are touching and penetration. In conclusion, systematic data collection and analysis have allowed a better knowledge of the populations characteristics and conducted the team to venture hypotheses about history of sexual abuse.
Child abuse: methodological support for a descriptive survey and for monitoring in a specialised team which takes charge of abused children.
Authors: Senterre C , Vanthournout B , Rebuffat E , Gerard M , Dramaix M
Published: March 2011

Child abuse is a well-known problem but still poorly documented in Belgium. Since 2005, SOS enfants that takes care of abused children tries to analyse the evolution of its populations. The team decided to create a data collector form for hospitalised children This tool included data on children and parental characteristics, criteria for hospitalisation, history and types of abuse and clinical diagnosis. Since 2008, the Department of Biostatistics supports the team for methodological and analytical process. A data entry program was locally implemented (with Epi 6) to improve the potential for ‘routine monitoring’ tool. The purpose of this paper is to present the major results of the analysis of the data collected between 2005 and 2008 (n=350 children). The abuse is confirmed in about 75% of the hospitalisations and in one in five cases, it was multiple abuses (often physical and sexual). Family histories of these children were also very complicated: history of abuse, reconstituted family, socio-economic difficulties, etc. In conclusion, systematic data collection and analysis have permitted a better knowledge of the populations characteristics and conducted the team to venture clinical hypotheses about history of abuse.
Assessment of knowledge of physicians about trauma/emergency care in public and private sectors in four districts of Sindh, pakistan
Authors: Baqir S M , Razzak J A , Khan U R , Heller D
Published: March 2011

Background

In Pakistan, currently there is only one institution, which offers postgraduate residency training program. Doctors from other specialties manage emergencies. Pakistan is vulnerable to natural and manmade emergencies. Therefore, our objective was to evaluate the emergency care knowledge of physicians across four districts of Sind province, Pakistan.

Methods

This was a cross-sectional study conducted between January and February 2009. The study included a convenience sample of 141 physicians staffing public and private sector health system. We developed a 35-item physician knowledge test derived from the Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) curriculum. The instrument was validated through pilot testing on 23 senior students at the Aga Khan University Medical College.

Results

Scores were uniformly poor, across all levels of physician training (p 0.34), tiers of care provided (0.74), public versus private (p 0.6) and districts (p 0.055) surveyed. The overall mean score was 11 (SD 5) of 35, and not one of the 141 physicians surveyed achieved a score above 20. Scores were low on several fill-in questions, such as on basic treatments for acute myocardial infarction (9% of respondents answered correctly), interpretation of electrocardiograms (3%) and the steps in basic life support (8%).

Conclusion

The knowledge deficit was severe and this likely compromises the ability of health facilities to use their available supplies most effectively. Better physician training would likely be the single most cost-effective way to ensure the optimal use of existing resources for emergency care in Sindh.
An analysis of the cases of falls and the causes of falling accidents in children who are in the 0–6 age group and live in Kirikkale: a Turkish example
Authors: Erkal S
Published: March 2011

Accidental injuries have been identified as a major threat to the health and well-being of children. Since they may cause serious physical damage and may even lead to death, especially in the case of accidents in early childhood, the issue of accidents at home is still of great importance around the world, including Turkey. This study was designed and carried out to analyse the falls and the causes of falling accidents in children who are in the 0–6 age group and admitted to the H. Hidayet Doğruer Maternity and Children's Hospital during 2007. The study was performed on children (n:95) who are in the 0-6 age group and applied to the Accident and Emergency Unit at the H.Hidayet Doğruer Maternity and Children's Hospital between the dates of 1 January 2007 and 31 December 2007. Data of the study was collected via a questionnaire form which was applied to the mother in the family. Of the children, 58.9% were male and 41.1% were female. In the 2–3 age group, most falls (43.1%) took place living room, and accidents that resulted from falling down stairs (23.1%) ranked first. For the prevention and control of falling accidents, protective measures should be taken at home; these would primarily be aimed at protecting the preschool age group which is the highest risk group.
Traffic injury prevention in Cluj-Napoca, Romania
Authors: Chereches R M , Rus D , Ajtai N , Sirlincan E O
Published: March 2011

Low and middle income countries still lack proper surveillance such as registries that document traffic fatal and non-fatal injuries. Literature indicates that traffic injuries prevention can be enhanced based on rigorous documentation and reliable data. The Romanian Road Safety Plan is a national centralised program, offering little room for local initiative and evidence based approaches. The traffic injury prevention measures implemented so far involve very few health professional and disregard new technologies. An innovative pilot-project conducted in Cluj-Napoca, Romania used police reports and emergency department data to draw a map of accidents using Global Information Systems (GIS) technology. According to the Police Department Database pedestrian injuries account for 70% of traffic related injuries. More than a third of the traffic crashes occurred under normal weather and road conditions, during daylight and on dry road. GIS has been used to identify traffic injury hot spots with the primary scope of developing future injury prevention strategies in Cluj-Napoca, Romania. This local need based technologically enhanced initiative, uses GIS to assess high risk areas of the city and to allow the local Police Departments to take corrective actions. The digital map enables to locate precisely the hotspots from the city and to develop a need-based intervention plan. GIS has proved to be a successful tool, specific hotspots being detected and mapped. Further research is needed to determine environmental related causes. Furthermore, population based educational interventions are encouraged.
Comparison of blood alcohol levels with breath alcohol levels measured using the Drager 7110 MKIII breathalyzer
Authors: Peleg K , Gopher A , Jaffe D H , Siman-Tov M , Almog S
Published: March 2011

Background

Breathalyzers have become an indispensable tool for monitoring alcohol levels among drivers for evidential purposes. Israels traffic police, like many other countries worldwide, uses the Drager 7110 MKIII, which is correlated with blood alcohol levels at a 2100:1 partition ratio. Recent uncertainty with this association resulted in a legal standstill in the conviction of drunk drivers.

Objective

To assess the correlation between breath alcohol, measured using the Drager 7110 MKIII-IL breathalyzer, and blood alcohol concentrations (BAC).

Methods

Sixty-one healthy volunteers, ages 21–37 years, participated in a blinded study. Participants were administered between 0.89 and1.16 g 95% alcohol/kg body weight according to gender mixed with juice. Breath and blood samples were taken simultaneously before and at 30-, 60- and 90-min after alcohol ingestion. Breath alcohol concentrations were measured by police officers trained in the use of the breathalyzer and under field conditions. Blood alcohol levels were determined by head-space gas chromatography technique in an accredited laboratory.

Results

A total of 242 valid blood/breath tests were performed on 61 participants. The correlation coefficient between breath and blood alcohol levels was high (r=0.983). The regression equation for the prediction of breath alcohol was equal to 10.224+4.292*blood alcohol. The sensitivity and the specificity of the breathalyzer instrument were 97% and 93%, respectively. Blood to breath alcohol ratio was 1:2231242.

Conclusions

The Drager 7110 MKIII IL breathalyzer was highly correlated with BAC. The results of this study were used in the Israeli courts as evidence for the reliability of the Drager 7110 MKIII breathalyzer measurement.
Injuries and violence in Nepal: a review
Authors: Kumar J S , Suvash S
Published: March 2011

Nepal lacks sufficient data on injury and violence. Studies have been done in different regions but there is not a nationwide study on this topic. So, we've designed this review to get a cumulative picture of injury and violence status in Nepal.

Methodology

We searched Medline database, Google scholar database and also all the national medical journals for relevant studies on injuries and violence. Our eligibility criteria included studies done in Nepal, evaluating the incidence of different forms of injuries and their causes and effects. We excluded case reports and reviews. Though we found 120 articles through our literature search, we included only 23 studies that met our eligibility criteria. We made cumulative analysis wherever possible.

Results

All the studies were descriptive. In overall, the incidence of injuries was twice as common in male as in female (Male:Female = 2.1:1). The economically active population between 20 and 50 years of age was mostly involved in injuries. Road traffic injuries were the most common form of injuries, most of which (42.5%) involved motorcycles. Pedestrians (48.6%) were the most vulnerable group of population. Falls (48.9%) were the most common cause of neurotraumatic accidents. Other injuries occur at workplace, home and in the community.

Conclusion

Our review suggests that injuries and violence pose a big problem; road traffic accidents make the most part of it.
Trends in fatal crashes involving young and older drivers in Great Britain
Authors: Jones S J , Palmer S R
Published: March 2011

Young driver (aged under 20; YD) crashes are a leading cause of road death across Great Britain (GB) and the world. We compared trends in road traffic crashes involving YDs against those involving only older drivers (OD). STATS19 data were obtained for GB for 2000–2007. Fatal crashes involving YD and OD were identified. Annual potential years of life lost (PYLL) were calculated against a reference age of 75 for 2000–2007. Average PYLL per death per crash for YD and OD crashes were calculated for GB and Wales, England and Scotland separately. Between 2000 and 2007, numbers of OD crashes dropped 23.8%, but YD crashes only 5.0%. However, fatal YD crashes increased 15.3%, compared with a 15.4% drop in fatal OD crashes. YD crash fatalities increased 11.4%, compared with a 16.3% drop in OD crash fatalities. In Wales, YD crashes increased by 8.2%, compared with a 15.9% decrease in OD crashes. England saw 5.9% decrease and 24.4% decrease respectively, with 4.9% and 19.7% decreases in Scotland. On average each year, across GB, there were 48.4 PYLL per YD crash death compared with 33.2 per OD crash death. More PYLL were lost by YD crash fatalities in Scotland (51.1 years) than Wales (50.5 years) and England (47.9 years). There is an urgent need to address the YD crash and casualty problem. New approaches need to be considered. Many countries have successfully used Graduated Driver Licensing to reduce YD crash risk. Such an approach should be implemented in GB.
Road traffic crash casualty injury severity crashes involving young drivers compared with older drivers
Authors: Jones S J , Palmer S R
Published: March 2011

In the UK, road traffic crashes are declining for all except young drivers (YD; aged 17–19). Comparison of the severity of injuries to passengers and pedestrians in YD crashes with crashes involving older drivers (OD; 20 years+) was carried out to help target prevention efforts. STATS19 data were analysed for 2000–2007 for Wales. Crashes involving YD and OD were identified. Casualties were grouped into pedestrians and passengers and analysed by age, sex and severity of injury. There were 12 191 pedestrian casualties and 32 265 passenger casualties. Pedestrians injured in YD crashes (n=784, 6.4%) were more likely to die or suffer killed and serious injury (KSI) than those in OD crashes (25.5% vs 18.8%; OR 1.48, 95%CI 1.25 to 1.75). Passengers in YD vehicles in YD crashes (n=5629, 9.0%) were also more likely to be KSI (12.0%), than those in OD vehicles in YD crashes (6.6%; OR 1.92, 95%CI 1.59 to 2.33) or OD vehicles in OD crashes (8.7%; OR 1.44, 95%CI 1.30 to 1.59). Crashes involving YD cause significantly more serious and fatal injuries to pedestrians and passengers travelling with the YD. Interventions to address these crashes are required urgently. Many countries have successfully used Graduated Driver Licensing to reduce new YD crash risk. It is time that such an approach was implemented in the UK.
Traditional physical exercise and tai chi comparative study among older people in Hungary
Authors: Benyi M , Vamos M , Meszaros L , Czudar P , Rakos-Zichy P
Published: March 2011

Introduction

Making physical exercise among elderly is not really popular in Hungary. Traditional physiotherapy is preferred mostly among people with disability. As far tai chi is the evidence based good practice in fall prevention, but it was never tested in Hungary, two parallel studies were completed for comparison. Data and methods in year 2009 two exercise programs were offered for elderly groups: tai chi and traditional physical exercise. In tai chi groups there were 104 persons (35 persons younger than 65 years, 69 persons 65 years or older). To traditional physiotherapy groups 98 persons attended (among them 45 were younger than 65.) Both types of exercise took 1 h per week and lasted 10 weeks. The results were tested with SF36 test. Differences were measured between given answers before and after courses. Statistical program SPPS 11.0 was used.

Results

In tai chi group among people younger than 65 years, we could find nine answers where people mentioned development in their health status. In group of elderly above 65 years four answers were significantly positive. In traditional physical exercise groups among elderly less than 65 years old nine answers were significantly better after than before; in group 65 years and elder six answers. In both groups two answers show significantly better results after training than before.

Conclusion

Both types of exercise are almost equally efficient for elderly. Results can help the acceptance of tai chi, as a method among specialists, who deal with injury prevention among elderly.
The preparedness of Ugandan schools for fires
Authors: Nakitto M , Lett R
Published: March 2011

Introduction

There have been numerous media reports on school fires in Uganda. In April 2008, a primary school dormitory caught fire and 20 children burnt to death. This incident increased public interest. One year later, an assessment on school preparedness was performed.

Methods

50 schools (day and boarding) were randomly chosen and stratified by level of education (20 primary, 20 secondary, 10 post secondary) in the five divisions of Kampala. A questionnaire was administered to key informants who were school teachers. Trained research assistants assessed training, fire equipment and the school environment. Direct observation was done. Frequency analysis was done.

Results

Schools (72%) were government owned with 92% mixed students. Schools (50%) had ever been trained on fire safety. Schools (19%) had trained before the incident. Fire extinguishers usage, fire fighting and causes of fires were part of training course. There was no formal training curriculum in schools. Training lasted from a minimum of 1 h to maximum of 1 week. 73% of teachers trained passed on the knowledge to their students. 60% of schools had persons in charge of fires. 84% of schools had no fire safety plans in place. 34% of schools had fire assemblies. 68% had fire extinguishers that were installed after the incident. 8% had fire alarm system in place. 68% had fire exits or escapes. 18% of schools had history of fires. Five schools had fire outbreaks in dormitories and received no help from fire brigade. 66% of schools had kitchen 1–60 m away from dormitories and classrooms. 22% of schools use paraffin lamps as alternative source of lighting when electricity is cut.

Discussion and conclusion

Majority of Ugandan schools are not prepared to deal with fires. Fire safety policies and standards should be addressed by the Ministry of Education and School Management.
Head injuries, factors associated, outcomes
Authors: Busingye D , Bua E
Published: March 2011

Introduction

Road traffic accidents are a major cause of injury and trauma in Uganda, of which head injuries are a major cause of morbidity and mortality among casualties.

Objectives

To determine the leading cause of head injuries, factors associated and the outcomes.

Methods

A retrospective study was carried out. Pretested questionnaires were filled in from the Records department on patients with head injuries in the years 2007, 2008 and 2009. Data was entered using Epi data software, cleaned and exported to SPSS for analysis in Respect to the study variables.

Results

The median age was found to be 28. 90% were as a result of road traffic accidents of which 86% were motorcyclists. Most injuries occurred between 8 pm and 2 am. Trend showed Increase in the number of injuries and complications thereafter.

Conclusion

The increase in the number of head injuries among young energetic men causes a strain on the country's labour and resources. There is great need for education and public awareness on the traffic rules, provision of protective gear to the cyclists and passengers and reduction of motorcycles in the city.
Managing and promoting child safety in the city new holistic model
Authors: Shira K , Dafna K , Michal K , Gali B S , Zvi B , Michal H L , Silbinger O
Published: March 2011

Introduction

Unintentional injuries are a major cause of child mortality and morbidity in Israel. Municipal authorities promote child safety via different activities and departments; however child safety is not recognised as a single integrated issue in need of comprehensive management.

Objective

To develop an holistic model for Safe Cities, combining methods of organisation counselling, risk management and health promotion. Concept ‘Safe Cities for Children’ is based on the safe community model, with the addition of supplementary domains including: the City as an Organisation. Using tools of organisation counselling to incorporate a safety culture in the municipality. Functional Responsibility. Recognition of and obligation to the municipality's functional responsibility to see to child safety. Safety Management and Promotion. Commitment to comprehensive child safety management, as well as engage in promotion of child safety via activities. Standards and tools (1) Safe City Guideline developed based on OHSAS 18001, Safe Community model and international labour organisation (ILO) documentation. (2) Initial risk survey and mapping of the state of child safety in the municipality as a baseline prior to launching the program. (3) Minimal Data Set (MDS) a uniform MDS on child injuries adapted for municipalities. (4) Organisation counselling model – developed for counselling municipalities in the field of child safety.

Validation

Twenty municipal authorities in Israel have joined the Safe Cities program since 2001; half are in the low socio-economic bracket including Arab and Jewish Ultra Orthodox population. Results of initial evaluation of the model will be presented.