bluuebunny/crossref_metadata_2025 huggingface dataset:
Motorcycle helmet use in Neuquen, Argentina
Authors: de Hoyos G , Ungaro J
Published: March 2011

Introduction

There have been an increasing number of traffic injuries among motorcyclists in Argentina recently. An important growth in the number of circulating motorcycles and lack of helmet use among riders seem to be closely related to this problem.

Objective

To assess the prevalence and possible factors associated with helmet use among motorcycle riders in the city of Neuquen, Patagonia, Argentina.

Material and Methods

A non-participative, structured observation method was used. Observations were conducted in twenty different points in the city centre, suburbs and high speed roads. Bidimensional and multidimensional were carried out.

Results

1069 observations were made. 88% of drivers were males. Women were observed driving almost exclusively small motorcycles mostly in suburbs. One of four motorcycles carried passengers, 70% of them being women. Overall helmet use rate among drivers was 72% (64% in suburbs, 78% in city centre, 89% in high speed roads). No difference between genders was observed. Helmet use rate dropped to 42% in suburbs during weekends. The use on helmets declined to 37% among adult passengers and to 30% among children. Six different groups were identified by means of multidimensional analysis.

Conclusions

It seems motorcyclists remain inconstant with wearing helmet when they know enforcement is unlikely or believe risk is lower. However, this study shows a twofold increase in helmet use rate in drivers and passengers in comparison to 2005. Discontinuous but rather effective education and enforcement efforts have taken place in this period. Support to sustained action programs is required.
Ethics and public health preparedness: creating a forum for discussion of ethical issues and community values
Authors: Degutis L. C. , Traugh K. , Landwirth J. , Shaw J.
Published: March 2011

Objective

To create a process by which ethical issues related to disaster planning and preparedness are identified and discussed among a multidisciplinary group.

Method

A collaboration between the Yale Center for Public Health Preparedness and the Yale Center for Bioethics was initiated in order to address the ethics of preparedness for disasters and other public health emergencies. Participants included faculty, Center staff, public health practitioners, ethicists, community members, students.

Results

The forum resulted in the following: (1) an 18-month long case-based series of discussions on various aspects of preparedness planning under the topics of constraints on liberty, communications, resource allocation, work force issues, vulnerable population, ecological/environmental issues; (2) a year long series of discussions focused on ethical issues and community surge; and (3) a project on alternate standards of care in disaster situations in collaboration with the state department of public health. The case-based series is currently being developed into a curriculum for study ethical aspects of preparedness. The community surge discussions provided insight that was used in the development of altered standards of care policy for the state. The altered standards of care project is being discussed in communities around the state in order to solicit input from community members before the document is finalised.

Conclusion

The creation of a multidisciplinary forum for discussion of the ethics of public health preparedness has informed the development of policy that will impact communities, and is leading to the development of a curriculum in the ethics of preparedness.
Implementing a holiday cooking-related burn injury prevention program: don't get burned by the bird
Authors: Shupp J , Woods J , Hollowed K , Ammons L , Pavlovich A
Published: March 2011

Grease burns and other cooking related injuries have an especially high incidence around the November/December holiday season. A study done in 2004 at our Burn Center showed that the incidence of cooking related burns was 41.1% higher during the week of the Thanksgiving Holiday compared to surrounding weeks. The Burn Center at Washington Hospital Center in partnership with the DC Firefighters Burn Foundation set out to create a 2 prong approach to attempt to prevent these cooking related burns. First a prevention video was created outlining the proper handling of disposable aluminium pans often used for cooking turkeys. The video was posted on YouTube and email blasted to all members of the hospital staff. Second, a flier was created to be handed out at all Burn Outreach and Education events. This flier entitled Dont get Burned by the Bird featured a picture of a turkey standing in a pan of spilling grease. It included instructions for the safe handling of pans while cooking. The video received 159 views on YouTube and the flier has been passed out at numerous Burn Outreach and Education Events. Data collection is ongoing concerning the effect these measures have had on prevention of cooking burns. This year, after implementation of this program there was a reduction in grease burns. Further data collection is ongoing.
Road traffic-related deaths among vulnerable road users. Argentina, 1980 – 2007
Authors: Ubeda C , Espitia V , Peltzer R , Perinetti A
Published: March 2011

Introduction

In Argentina occurred 5914 road traffic deaths in 2007, which is equivalent to 16 people per day. A total of 2328 were vulnerable road users with 6 per day. The objective of this study is to describe the burden of vulnerable road users deaths in Argentina.

Method

A descriptive longitudinal study based on secondary data was conducted. Pedestrians, motorcyclists and cyclist were included as vulnerable road users (VRU). Data from Ministry of Health and Road Traffic National Agency were used in the analysis. We calculated general and specific rates for age and sex of VRU by province.

Results

VRU accounted 39.5% of the total road traffic deaths with 17.5% motorcyclists, 15.2% pedestrians and 6.7% cyclists. The risk of death increased for pedestrians 55 years and older and for cyclists aged 70 and 80 years. Rates among motorcyclists were higher in the group 15 and 25 years old. Over two thirds (76%) of the deaths were registered in male. Men also predominated in crashes involving bicyclists. There were differences among provinces: pedestrians were predominating in the North West region and Capital Federal with 30% of the total. In Santa Fe, Cordoba and La Rioja (North Central region), motorcyclists were 20% of deaths.

Conclusion

Combined information from different data sources provides a broad vision of the burden of the problem. The results showed the need to develop strategies for protecting VRU especially those over 60 years, which pose an increased risk relative to other users.
Firefighter Foundation and Regional Burn Center Collaborate to Reduce Burn-Related Injuries in the Elderly
Authors: Woods J , Hollowed K , Pavlovich A , Shupp J
Published: March 2011

In the USA seniors (age 65 and older) account for over 250 000 burn injuries annually. More than 1200 seniors die as a result of fire each year. These fires are usually a result of smoking materials that ignite clothing or upholstery. Cooking accidents account for the largest number of non-fatal burn injuries in this population. The District of Columbias (DC) Office of Aging reports that approximately 100 000 DC residents are over age 65. Given these statistics an initiative was started between the DC Firefighter Burn Foundation (DCFFBF) and The Burn Center at Washington Hospital Center. In 2009 The Seniors Guide to Fire and Burn Injury Prevention was created. This guide contains approximately 20 pages of information on residential fire prevention, which includes topics on cooking, electrical, heating and smoking safety. The guide also contains information on what to do in the event of a fire or burn injury along with a home safety checklist. The guide was designed for a low literacy level and contains easy to read information and illustrations, beneficial to those with language barriers as well as those with diminished eyesight, often experienced by many older adults. The goal of this program is to reduce the number of burn injuries and fire related deaths in the regions senior population. As part of the Burn Centers Outreach and Education programs this publication will be distributed at all outreach activities that involve seniors and annual data are being collected on senior fire-related injuries as a metric of impact.
Health risk behaviors and injured patients: an exploratory study
Authors: Degutis C , Busch S , Pantalon M , Fiellin D , O'Connor P , D'Onofrio G
Published: March 2011

Objective

To determine whether patients presenting to the emergency department (ED) with injury were more likely to report risky health behaviours than pts without injury.

Methods

Adult (age>18) patients with non-life-threatening injury or illness presenting to the ED were screened for following: alcohol consumption, smoking, exercise, seatbelt and helmet use.

Results

16 299 patients were screened; 5327 (33.5%) with injuries; 6868 (43.2%) male. Injured pts were significantly more likely to be male (36.4% vs 31.4%; p=0.000), younger (43.7 vs 46.1; 95% CI 1.85 to 3.10), drink alcohol (39% vs 36%; p=0.003); exercise regularly (57.9% vs 50.7%; p=0.000); and significantly less likely to wear a seatbelt regularly (33.6% vs 66.4%; p=0.000). There was no difference in reported cigarette smoking between injured and non-injured patients (66.9% vs 67.7%, p=0.331). There were no significant differences in drinking patterns (# of days of drinking per week, usual # of drinks per occasion, maximum # of drinks per occasion) between injured and non-injured patients.

Conclusions

While there were differences in some health behaviours (alcohol consumption, exercise and seatbelt use) between injured and non-injured pts presenting to the ED, there were no differences in drinking patterns between injured and non-injured patients who reported any alcohol consumption. This supports the need to continue to screen for alcohol problems and provide interventions for all ED patients.
Fall-related hip fracture trends 1991–2008: reduction of falls or increase in bone resistance?
Authors: Burrows S , Robitaille Y , Gagné M
Published: March 2011

Background

Hip fractures (HF) are one of the most serious consequences of falls. In several countries, the incidence of HF has declined in recent decades. Primary factors responsible for this downward trend are unknown, but a reduction in exposure (falls) or increased resistance (bones and body mass index (BMI)) may have had an impact.

Objectives

(1) Examine fall-related HF trends in women ≥50 years from 1991–2008 in Quebec, Canada; (2) Examine trends in other severe fall-related injuries non-related to bone fragility, for example, traumatic brain injury (TBI).

Methods

Hospital admissions following falls (E880-E888; W00-W19, X59.0) with HF, TBI or other severe diagnosis (diagnosis survival probability <0.95) were selected. We used negative binomial regression models with annual percent change (APC) to assess trends in each of these fall-related injuries. Both age-specific (50–64, 65–74, 75–84 and ≥85) and age-adjusted incidence rates were calculated.

Results

The age-standardised rate for fall-related HF decreased (APC:−1.6%) from 292 to 237 per 100 000 in women ≥50 years between 1991–2008. HF rates declined in each age group. In contrast, the age-adjusted rate for severe fall-related TBI and other injuries increased throughout the study period (APC:+6.5% and +3.8%, respectively). These upward trends were observed for all age groups.

Discussion/Conclusion

The downward trend of HF seems to point towards increased bone/BMI resistance, since other severe fall-related injury rates (not related to such resistance) have increased.
Intangible cost of road traffic injuries: a phenomenological approach
Authors: Pérez-Nunez R , Pelcastre-Villafuerte B , Hijar-Medina M , Vila-Burgos A , Celis A
Published: March 2011

To explore the consequences of road traffic injury (RTI) in terms of health, individual-family life and its implications on the households economies, the experience of 12 injured and 12 relatives of RTI-deaths was documented using phenomenological approach. Semistructured interviews were analysed throughout critical discourse analysis. Changes in physical and mental health were observed in both injured and relatives of those who died from RTI what implied changes in daily activities temporally or permanently and even to the redefinition of future life. People also change the way they see and act in life learning from their experience: preventive attitudes were evident in their discourse. This also represents a teaching experience for others: consciously and unconsciously survivors transmit a road safety message. Changes in family life were as simple as acquisition of new responsibilities or roles inside the household and as complicated as changes in families composition, sometimes affecting intra-familial relationships and translating in family tension and problems, although occasionally makes families become closer. Associated unexpected expenditures and loss of income have consequences in the short, medium and long term that unbalance households economies and immerse people into a constant stress. Individuals and families future plans are occasionally conditioned to whether they have or not debts. Economic dependency was sometimes observed as well as uncertainty about future life (ie, households sustainability). Sometimes, households change and adapt their life to what they now are able to afford, having important repercussions. Consequences observed in the individuals discourse have no sense in monetary terms. Evidencing what people live after a RTI, allows us to learn from their experience and highlights the need of preventing these events.
Association of body mass index, sleep quantity, sleep quality and sleepiness among express bus driver
Authors: Mani K , Fazelin N , Ismail S
Published: March 2011

The number of road crashes involving trade vehicle especially buses and lorries are increasing every year. The number of commercial vehicles, which involved in crashes increased by 25.35% within 5 years from 2000 to 2005. Besides that, percentage of road crashes involving buses also had increased alarmingly by 131.25%. Driver sleepiness is a potentially important risk factor of road crashes and related injuries. The main objective of this study is to identify the association between body mass indexes, sleep quantity and sleep quality towards sleepiness among express bus drivers. This is a cross-sectional study conducted in Johor Bahru, Johor. Weighing scale and body metre were used in measuring weight and height while standardise questionnaire which consist of three parts namely part 1 covering socio demographic details, part 2 contains Epworth Sleepiness Scale and part 3 contained 7 days self reported sleep log. Sleepiness level was measured using Epworth Sleepiness Scale. Measurement was conducted before the respondents start their job. Eighty-five respondents were involved and 18 (21.2%) of them were found to be sleepy. χ2test or Fishers exact test revealed that there were only three variables found to be significant. They are body mass index (p=0.002), sleep quantity (p=0.038) and working experience (p=0.006) whereas four variables found to be insignificant and they are age (p=0.050), sleep quality (p=0.617), driving duration (p=0.078) and driving distance (p=0.063). From the result, the factors that influenced the sleepiness level among the express bus drivers were body mass index, sleep quantity and working experience.
Seat belt wearing in Nanjing and Zhoushan, China, Post regulation
Authors: Routley V , Ozanne-Smith J , Li D , Wang J , Yu M , Zhang J , Wu M , Qin Y , Wang P
Published: March 2011

In response to Chinas rapidly developing economy, motorisation and increasing road traffic fatalities, the Chinese national road traffic safety law, requiring seatbelts to be worn where fitted, became effective May 2004. The research programme aimed to evaluate comparative changes in seatbelt wearing patterns in the contrasting Chinese cities of Nanjing, Jiangsu Province and Zhoushan, Zhejiang Province in 2005–2007. Following traffic familiarisation and piloting, roadside observations of urban seatbelt wearing were undertaken for 68 992 vehicles and 118 607 occupants. To interpret these results occupant interviews, focus groups and media reviews were conducted. Seatbelt wearing was significantly higher for drivers (49.9% Nanjing, 47.4% Zhoushan) than for front seat passengers (9.1% Nanjing, 1.0% Zhoushan) and virtually non-existent for rear passengers. Wearing generally declined significantly each year. An absence of child restraints and belt tampering, a practice of 12–15% of taxi drivers, was observed. Seatbelts were reported by interviewed drivers as fitted in almost all front and less than 50% of rear seats. Reasons for never wearing were most commonly feeling trapped and uncomfortable; for regular wearers feeling safer and not wanting to be fined. Focus group participants largely agreed on the need to wear seatbelts on highways in the front and not in the rear seat, agreement was lacking on wearing for slower city traffic. Media was not sustained. In conclusion there is need to promote awareness that injury can occur at relatively low speeds and to enforce correct wearing for taxi drivers. Wearing habits should be developed by consistent, visible and sustained enforcement.
Improving health and safety and injury management performance in large organisations: preliminary insights from an evaluation of the Victorian employer performance management program
Authors: Mitsopoulos-Rubens E , Lenn M , Trotter M , Day L
Published: March 2011

Introduction

The Employer Performance Management Program (EPMP) is an initiative of the workplace safety authority in Victoria, Australia (WorkSafe Victoria). It aims to achieve (1) greater insight into factors affecting occupational health safety (HS) and injury management (IM) in large organisations and (2) consequent HS and IM performance improvement. The EPMP includes a HS and IM performance audit, performance report preparation and action plan development. We report preliminary findings from a comprehensive evaluation of the EPMP.

Methods

Focus groups were held with WorkSafe EPMP performance managers after the first round of organisations had received their performance reports, and again 6 months later after the second round of organisations had received their reports. A semi-structured discussion guide was used to identify any potential barriers to the programs delivery and effectiveness.

Results

Themes to emerge included an overall positive perception of the EPMP in terms of its strategic focus and proactive, collaborative approach. Concerns were raised regarding the adequacy of the audit tool, for example, in terms of its suitability to multi-site/division organisations and insufficient coverage of HS issues relative to IM. Low organisational engagement was identified as a potential barrier to the programs success.

Conclusion

The EPMP has the capability to produce sustainable change in the HS and IM practices and performance of large organisations. The potential barrier of low organisational engagement needs to be addressed to optimise program success. These results will be incorporated into the broader evaluation, which includes a claims analysis and a cohort study of EPMP organisations.
Interdisciplinary attention program for women victims of violence older than 14 years old prevention of lesions – Developed in Mar del Plata-Argentina 2003–2008 sexual violence and its consequences
Authors: Galeano M G , Martinez L , Coronel E
Published: March 2011

It is a personal, social and political problem. It destroys the life of millions of people and it affects to the group of the society. Being tolerated, denounced, according to social and cultural norms. It is a material or symbolic attack that affects the freedom and dignity, it produces effects to short and long term, in the physical and psychic integrity of people.

Objective

To improve the assistance by means of the development of norms and strategies for the integral attention of the different sectors interveners.

Results

It was conformed a Committee to assist and create a network for the victims in the area of General Pueyrredn. A Manual of Strategies of Attention, Prevention and an algorithm was made to be followed by the different institutions interveners: Judicial, Police and Health Systems. Programs were coordinated by INE. Trained: 300 professionals. 282 women were attended during the period 2003–2008. Age average: 24, medium 21 years old. An Epidemic Surveillance System, mapping cases, is ongoing. The victims' perception: Nuclear Family: behold. Health: grateful for assistance given and ulterior follow-up. Judicial System: the discomfort of results, (70%).

Impact

Not wanted pregnancies have been observed neither HIV infections. Serial rapists arrested. Decrease of cases.

Conclusion

The network created by the committee starts at the moment of the victims complain at the police station, it is given immediate antiretroviral treatment by forensic physicians, assisting the victim. Enabling epidemiological surveillance, manual and norms writing as well as interdisciplinary training.
Justifications for wife beating among Iraqi women
Authors: Sorenson S B
Published: March 2011

Background

Little is known about attitudes toward domestic violence in low- and middle-income countries. Less yet is known about such attitudes in the Middle East.

Methods

Data are from Iraq's 2006 Multiple Indicator Cluster Survey (MICS3), an in-person representative sample survey. Response rates were high: 98.6% of the selected households and 98.6% of the selected 15–49 year old women participated. Women (N=27 186) were asked whether a husband would be justified in beating his wife under five specific circumstances. Simple frequencies and multivariate logistic regressions were calculated.

Results

Nearly 60% of study participants said that a husband was justified in beating his wife: 48.8% if she goes out without telling him, 42.9% if she neglects the children, 37.5% if she argues with him, 34.2% if she refuses sex and 20.6% if she burns the food. AORs indicate that women's beliefs that a husband is justified in beating his wife in each of these circumstances were higher among those who were married, less educated, and from rural areas. Among the married, those who were less educated, from rural areas, married to a blood relative (59.0% of the sample), or under the age of 22 when married (73.2% of the sample) were more likely to report that a husband is justified in beating his wife.

Conclusions

Iraqi women appear to support wife beating most when the woman has violated her traditional role as a woman, a mother and lastly, as a wife.
Present status and problems of traffic injuries in China
Authors: Zhou J , Qiu J , Zhang L , Wang Z , Wang S
Published: March 2011

According data provided by China Traffic Management Bureau showed that the traffic crashes and traffic injuries were triumphantly controlled and decreased remarkably year by year since 2003, as suggests that the safety precautions have gotten great durative effects and have gotten a lot of successful experiences after China Road Traffic Safety Act brought into effect in 2004. We have carried out some in-depth investigation to some areas of China and found that China traffic safety situation was still not as good as the announcement data. Although number and the casualties of traffic crashes have not continued to increase rapidly again, but the number of traffic crashes still maintained at a high level. Through careful comparison, the author found that China's current traffic and traffic injuries in the calculation of statistics and reporting requirements and mechanisms were different from the international's, which has led to the huge differences, and that is disadvantage for the Chinese transportation injury's prevention and the control. This article has carried on the analysis discussion on these data and the problems
Bias in hospital samples used for injury research based on consent wording
Authors: Pless B , Hagel B , Keays G , Zhang X , Magdalinos H
Published: March 2011

Background

Many injury studies involve samples of hospitalised or emergency room emergency department patients. In studies involving follow-up, consent is required when patients are first identified. When the proportion who refuse is high, the study sample may be biased in ways that distort the validity of the results. This study aimed to determine if wording requiring active consent resulted in more refusals than wording that was essentially passive that is where consent is implied in the absence of direct refusal.

Methods

The Canadian Hospital Injury Reporting and Prevention Program (CHIRPP) is based in 14 hospitals, 10 being paediatric. It uses a two-page questionnaire to describe how the injury occurred and what was injured. We chose 5 of the 10 paediatric hospitals; 3 used passive wording and 2 used active wording for consent to follow-up. We employed logistic regression to analyse the effect of wording on consent rates and whether the effect was influenced by patient demographic and clinical characteristics.

Results

63% of parents gave consent for follow-up at hospitals using passive consent wording versus 53% where active wording was used. Refusals were highest for 15–19 year olds, families in lower income neighbourhoods, and motor vehicle passenger injuries. After covariate adjustment, passive wording increased likelihood of consent twofold.

Conclusion

Caution is needed when interpreting results from studies using hospital samples, especially when wording of consent for follow-up requires direct affirmation.
Empirical basis for adopting a theory-driven approach to preventing alcohol and other drug impairment (AOD) in the workplace
Authors: Davey T , Davey J , Freeman J , McClure R
Published: March 2011

Background

A State-based industry in Australia is in the process of developing a programme to prevent alcohol and other drug (AOD) impairment in the workplace. The objective of this study was to determine whether the Theory of Planned Behaviour can help explain the mechanisms by which behaviour change occurs with regard to AOD impairment in the workplace.

Method

A survey of 1165 employees of a State-based industry in Australia was conducted, and a response rate of 98% was achieved. The survey included questions relevant to the Theory of Planned Behaviour: behaviour; behavioural intentions; attitude; perceptions of social pressure; and perceived behavioural control with regard to workplace AOD impairment.

Findings

Less than 3% of participants reported coming to work impaired by AODs. Fewer than 2% of participants reported that they intended to come to work impaired by AODs. The majority of participants (over 80%) reported unfavourable attitudes toward AOD impairment at work. Logistic regression analyses suggest that, consistent with the theory of planned behaviour: attitudes, perceptions of social pressure and perceived behavioural control with regard to workplace AOD impairment, all predict behavioural intentions (p<0.001); and behavioural intentions predict (self-reported) behaviour regarding workplace AOD impairment (p<0.001).

Conclusions

The Theory of Planned Behaviour appears to assist with understanding the mechanisms by which behaviour change occurs with regard to AOD impairment in the workplace. An occupational AOD programme which targets those mechanisms for change may improve its impact in preventing workplace AOD impairment.
Speeding among taxi drivers in Selangor, Malaysia
Authors: Mani K , Mun S W , Hayati K
Published: March 2011

A cross-sectional study was conducted in Selangor on theKuala Lumpur-Seremban plus Highway in 2007. The main objective of this study was to determine the factors that influence speeding among airport Limousines taxi drivers in Selangor. This study was conducted through the usage of radar gun followed by a questionnaire survey. Radar gun was used to get the speed-reading of the moving Limousines taxis on the roadside. Meanwhile, the questionnaire survey was conducted on the taxi drivers been tracked earlier using the radar gun. There were 137 drivers matched the observation and questionnaire data. From the total respondents, 88 (64.2%) of them were involved in speed violations while 49 (35.8%) complied. There were four variables found to be significant in relation to speeding: day of week (p=0.039), posted speed limits (p=0.000), total distances travelled per day (p=0.012) and previous accident frequency (p=0.047). There was more (73.8%) airport Limousines taxi drivers who did not comply with posted speed limits in weekend compare with weekday, which recorded. At 90 PSL, the violation was more (88.2%) compared at 110 PSL. There was higher (76.8%) speed violation for drivers who travelled 800 km or more per day compared to drivers travelling distances below 800 km (55.6%). 84.6% respondents who involved two or more times in road crash were more tend to speed while driving. Thus, this four factors need to be addressed for safety among taxi drivers.
He drove me mad – Advocacy strategies to address the needs of women driven mad by domestic violence
Authors: Hager D
Published: March 2011

Experiencing abuse in a domestic setting can cause women to become mentally ill and to abuse drugs and alcohol. Domestic violence and related services perform a crucial role in helping women to identify and escape from abusive relationships and the cycle of violence. In New Zealand, several hundred women, and their children, are denied access to women's refuge each year because they are perceived to have substance abuse or mental health problems. Other women are using mental health and drug and alcohol services that are only treating/responding to the presenting symptoms not acknowledging the abuse that these women are, or have been, experiencing. Other services – legal, social services etc – also fail to help and protect women who are mad or difficult. A small, voluntary group of women (Homeworks Trust) have been advocating for these women and a system wide constructive response to their problems and need for safety. Over the past few years they have developed a range of advocacy resources and strategies including interactive websites, a teaching resource, DVD and engaging in a town planning competition. This paper will demonstrate the resources that have been developed, discuss the theory behind the advocacy decisions that have been made, why the group aims for systemic change rather than direct service provision – and discuss how a small group of committed advocates, with very few resources, can make a considerable difference.
The competency of emergency medical operation in emergency medical personnel: advanced life support Unit
Authors: Wijakkanalan W
Published: March 2011

This research is descriptive research based on mixed methodology. The objective is designed to study the competency of emergency medical operation in emergency medical personnel: advanced life support unit in northeast of Thailand. The population used in the research includes the Advanced Life Support units from 19 northeastern provinces. The samples include Advanced Life Support units in 5 ambulance stations, chosen by multi-stage random sampling; Udonthani, Roi et, Nakhon Ratchasima, Surin, and Khon Kaen. The tools used in research, including Advanced Life Support unit record form, competency evaluation form of the Pre Hospital Registered Nurse (PHRN), Emergency Medical Technician-Intermediate (EMT-I), Emergency Medical Technician-Basic (EMT-B) and First Responder (FR) in preparation, communication, scene size up, patient assessment, on scene care, care in transit, lifting and moving and consignment the patient. Data collection: documentary method, structured interview method, participant observation method and competency evaluation method is applied by using triangulation technique. Analysed by content analysis and typological analysis. Research found various range of outcome depended on the various competency of Advanced Life Support unit. Some PHRN gain improve, some can gain very good, EMT-I can gain fair to good, while the ambulance driver (EMT-B or FR) can gain improve to good.

Recommendation

Emergency Medical Institute of Thailand should develop the competency that can not be scheduled of all level and review pre hospital care required to apply for the standard emergency medical operation protocol of Thailand.
Motorcycle helmet usage to improve road traffic safety in Vietnam
Authors: Trinh T A , Le Tuan P
Published: March 2011

The number and severity of road accident are increasing, especially motorcycle mode. 50% among the road accident was traumatic brain injury (TBI) with 25% rate of death. From 2007, the Government force motorcyclist to wear helmet, then the number of accident reduced 40%, TBI reduced 30% and the rate of death reduced to 15% for the short time. However, from the end of 2008, even accident number decreasing, number of TBI and death is jumping. This paper aims to analyse the reason of TBI and death happening increased, by doing specific surveys. The first survey was taken to 1038 motorcyclists to identify the use of helmet and reason of using standard/non-standard helmet including five factors: price, type, colour and form, brand, quality. The second survey was taken at the helmet market and the third survey toward 9 traffic safety agencies. It was reveal that most of people use non-standard helmet even those with certification stamp. According to the fourth survey that was taken to five hospitals, number of road accident into the hospital occupied of a whole. Out of road accident cases, a haft were physical-broken injuries and a haft were traumatic brain injuries. Data show in many cases, motorcycle drivers wear non-standard helmet (of a whole) or in a wrong way (left), then the accident would be heavy and the victim would suffer TBI. Therefore enforcement and education is very important to change people's attitude and awareness to improve road safety in Vietnam.
Operation of a child injury prevention program in connection with local medical institutes: Safety Doctor
Authors: Kim I , Ryu C , Choi I , Ham H , Shin E
Published: March 2011

Objectives

This program is designed to designate a dedicated doctor for each childcare facility, together with local medical institutes, childcare facilities and the public health centre. It also involves medical institutes providing various safety education for injury treatment and prevention, thereby performing a pivotal role in the local community's safety network aimed at reducing infant injury occurrence at daycare facilities.

Method

For project implementation, the Songpa District Office, Songpa Health Office, Songpa District Medical Association and Childcare Facility Association concluded an agreement on mutual cooperation, and chose medical institutes and childcare facilities that wanted to voluntarily participate in the project. Safety doctors conduct regular health checkups for infants at childcare facilities, provide education on injury prevention to teachers, provide advice on measures that should be taken in the event of an injury, and also provide first aid. The medical institutes display safety products, promotional materials and booklets in the waiting room. They thus operate a ‘local safety centre’ that provides information on the health and safety of children to their parents who are visiting the hospital.

Results and conclusion

In January 2010, a connection was made between 261 childcare facilities and 69 safety doctors. Children at childcare facilities are actively receiving health checkups and safety education. There are reported cases of injury prevention activities and immediate measures taken in the event of emergency situations. In addition. there is an increased level of satisfaction among childcare facilities and parents towards the safety doctor program.
Unintentional childhood injury surveillance in Karachi, Pakistan
Authors: Zia N , Khan U R , Razzak J A , Hyder A A , Sugerman D E , Puvanachandra P
Published: March 2011

Background

Unintentional injuries are a leading cause of death among children and young adults. Over 875 000 children ≤18 years of age die annually in the world as a result of injuries, mostly in low- and middle-income countries.

Objective

To study the demographics, types and outcome of childhood unintentional injuries in Karachi, Pakistan.

Methods

This surveillance was conducted from February to April 2007 in emergency departments (ED) of five major hospitals of Karachi. Karachi is the largest city of Pakistan and has a population of about 9.3 million of which 43.8% are children. Care-takers of children less than 12 years of age were interviewed regarding unintentional childhood injuries.

Results

This surveillance included 566 children out of which 67.7% were males and 60.2% were between the ages of 5–11 years. Most of the children were brought to the ED by private transport (56.9%). Injuries commonly occurred at home (48.1%) and during recreation time (45.4%). Fall (49.5%) and road traffic injuries (RTIs) (20.8%) were the commonest mechanisms of injury. Falls occurred most often from stairs/steps. Of the RTIs, 13.4% were pedestrian injuries and 11.5% were due to motorcycles. Majority of the children (79.3%) were directly discharged from the ED with short term disability (44%). There were three deaths, of which two resulted from RTIs and one from fall.

Conclusion

Our surveillance showed that male children were frequently injured. The frequent mechanism of injury was fall followed by road traffic injury. Most of the children were directly discharged from the ED.
Workplace violence nature, prevalence and risk factors among drivers and conductors in Maputo city, Mozambique
Authors: Couto M T , Lawoko S , Svanström L
Published: March 2011

Workplace violence is a worldwide phenomenon. Studies indicate that, physical and psychological violence against workers in the road transport sector is relatively common. This paper provides data on nature, prevalence and risk factors of such violence in the road passenger transport sector in Maputo city, Mozambique. In a cross-sectional survey was examined the nature, prevalence and risk factors for workplace violence in the road passenger transport sector in Maputo, the capital city of Mozambique. A sample of 504 participants was randomly selected from a population of 2618 registered bus, minibus drivers/conductors and taxi drivers. Results indicate that workplace violence, psychological and physical, is highly prevalent among drivers and conductors, with 77% reporting ever being abused and 64% being abused in the past 12 month. The most vulnerable groups were illiterate employees, bus drivers and conductors, employees with long experience and holding a supervisory position. In addition, high workload was associated with an increased exposure to workplace violence in the road passenger transport sector in Maputo city. Implications of findings for interventions are discussed.
INTEGRIS WP 5 injury disability indicators: towards a standardised methodology for measuring the burden of disability due to injury
Authors: Haagsma J A , Belt E , Polinder S , Lund J , Atkinson M , Macey S , Lyons R A , van Beeck E F
Published: March 2011

Priority setting in healthcare, surveillance and intervention is based increasingly on burden of disease and injury studies, which integrate mortality and disability. Injury, however, challenges the underlying methodology, not in the least because of the wide range of possible consequences and recovery patterns. INTEGRIS WP5 Injury disability indicators focused on the methodology concerning the disability component (years lived with disability; YLD) of the burden of injury. This is calculated by multiplying the number of injury cases, a disability weight and average duration of the health outcome. An inventory of available methods was made by addressing key questions that are raised when assessing the disability component of injury, namely (1) which injury cases should be included?, (2) how to distinguish cases by injury diagnoses? and (3) how to link injury diagnosis to disability information concerning the disability weights and the proportion lifelong consequences? With this inventory, for each of these methodological questions WP5 provided a theoretical framework and proposed recommendations to assess the disability component of the burden of injury. Additionally, an implementation tool including a set of 87 injury disability weights and proportions of lifelong consequences for 27 injury diagnoses have been determined. In the Netherlands, the WP5 tool has been applied in national injury estimations of the National Institute of Public Health, highly increasing the burden of injury compared the previously used, hampered, methodology. This allowed Dutch policy makers to base their decisions regarding resource allocation on a more complete burden of injury estimate.
Fatal occupational injuries underreported in Norway
Authors: Wergeland E , Gjertsen F , Lund J
Published: March 2011

Background

2/3 of all fatal occupational injuries (OI) in Norway are recorded by the Norwegian Labour Inspection Authority (NLIA). The other 1/3 is recorded by authorities of oil production, shipping, fishing and aviation. The register at NLIA has been regarded as being complete. The validity of this statement was studied.

Material and method

183 fatal OI for 2000–2003 were found at NLIA, 171 related to persons resident in Norway. The records of these were found in the national death register (NDR) by the unique personal number. In addition 43 fatal OI within the sphere of authority of NLIA were identified in NDR. The real number of fatal OI was estimated by a capture-recapture model.

Results

214 fatal OI were identified, 98 in both registers. Missing injuries in NLIA were related to national defence (1 of 9), health and social services (3 of 7), road traffic injuries (36 of 52), fatalities occurring in North of Norway and Spitsbergen (17 of 28). The highest risks for fatal injury (per 100 million working hours) were found in agriculture and forestry (7.0), and in transport and communication (4.1). The number of fatal OI to should have been recorded by NLIA was found to be 246.

Conclusion

The risk for a fatal OI in Norway seems to be 44% higher than shown in official statistics. Insufficient registration, especially of transport injuries, might result in misjudgements of size and trends of the occupational injury problem, and the need for prevention.
Successful outcome of an abandoned baby infested with maggots
Authors: Adesiyun O O , Adeboye M A N , Saka A O , Abdulkadir M B , Oloko A G Y , Lawal R I , Mokuolu O S , Mohammed S S , David G M
Published: March 2011

Child abandonment, which is a form of child abuse, is a common happening in Nigeria and other parts of the world. Other forms of child abuse include physical abuse, emotional abuse, neglect and sexual abuse. Some babies are sighted abandoned in gutters, by the riverside, on debris, or in pit latrine! Most of these babies are products of unwanted pregnancies which are usually from early sex. Abandoned babies generate enormous interest but very little academic or systematic study. The psychological state of these mothers is not studied because access to them is restricted or unavailable. However, Finders are usually emotionally moved. Pregnancy, though a physiologic state, is associated with a lot of risks such as haemorrhage, pregnancy induced hypertension or death from various complications of pregnancy and delivery. Considering the risks associated with pregnancy, its supposed to be difficult for a mother, after carrying a baby to term, to dump her newborn baby. Against this background, we hereby present a successful outcome of a nearly 4/7 old term female neonate found in a polythene bag already infested with maggots with decaying placenta. The baby was successfully managed and discharged to the Ministry of Social Welfare.
Necrotising fasciitis following circumcision of a male child by a quack – a danger sign
Authors: Adesiyun O O , Adeboye M A N , Abdurrahman L O , Saka A O , Oloko A G Y , Lawal R I , Mokuolu O S , Mohammed M S , Gobir S
Published: March 2011

Neonatal necrotising fasciitis (NNF) is uncommon and often fatal bacterial soft tissue infection that affects skin, subcutaneous fat, superficial and deep fascia. It is characterised by rapid, extensive spread of inflammation and systemic toxicity and also associated with a high mortality. Wound cultures are usually polymicrobial withStaphylococcus aureusas the predominant organism. NNF occurrence in neonates is uncommon because plastibell do crush the prepuce between a suture and underlying bell which drops off in 5–8 days. Plastibell can strangulate the prepuce producing devitalised tissue that might be more susceptible to a serious infection especially if done under unhygienic condition. We present a 21-day old term male neonate who developed scrotal swelling subsequently followed by extensive gangrene of the scrotal sac following an illegal and unhygienic circumcision using a generally safe means (plastibel). Wound swab microscopy yielded mixed growth. However, the immediate outcome of the child was favourable. In conclusion, we recommend that simple as male circumcision is, it should be done by qualified individuals maintaining the highest standard feasible.
Identifying injury diagnoses associated with a high probability of admission
Authors: Cryer C , Gulliver P , de Graaf B , Davie G , Langley J
Published: March 2011

Background

When making international comparisons of non-fatal injury, they are often based on hospital data, and are contaminated by health service effects. One way to reduce this contamination is to make comparisons using a case definition based on diagnoses that have high probabilities of admission.

Aim

To identify International Classification of Diseases (ICD) diagnoses associated with a high probability of admission.

Method

We identified international collaborators who had access to Emergency Department data whose diagnoses were coded to the ICD. A protocol for data provision was agreed with our collaborators. The submitted data was checked by the New Zealand team and then via liaison with the collaborators. Country-specific results were presented at the ICD 4- character level. Results were also contrasted between countries.

Results

The results show that the only injuries with strong evidence for high probabilities of admission, consistently across all collaborating countries, were fractured neck of femur and other femoral fractures (S720, S721, S722 and S723). Other injuries that were potentially consistent with high probabilities, but for which the estimates had wide CIs due to small numbers in some of the collaborators data, included: focal brain injury (S063), traumatic haemopneumothorax (S272), injury of the spleen (S360), liver or gall bladder (S361).

Outcome

The information generated by this project will inform all high income countries of those diagnoses that almost always get admitted to hospital. It will also suggest a case definition suitable for making international comparisons.