bluuebunny/crossref_metadata_2025 huggingface dataset:
Injuries related mortality in Iraq 2007; a reflection on the violence related mortality in emergency and OPDs
Authors: Al-Hussoni M , Rehman J , Al Himyeri N , Muhammedi R , Al Daghistani N K
Published: March 2011

Hospital-based data collected in OPD and Emergency of hospitals of Iraq on monthly basis was retrieved from the Ministry of Health and analysed for Incidence rates (IR).

The IR for the violence-related mortality in Iraq in 2007 was 37.63 per 100 000 person year. The major proportion of the fatal injuries during 2007 were gunshots (47%, IR 22.86 per 100 000 people) and explosions (30%, IR 14.77 per 100 000 person year). 59% of the fatal injuries in the capital city, Baghdad, were caused by gunshots (IR 30.84 per 100 000 person year) in 2007, while explosions caused 37% of the fatal injuries in the capital (IR 19.73 per 100 000 person year). Karkuk (explosions, IR 62.96 per 100 000 person year; gunshots, IR 55.09 per 100 000 person year) and Diala (gunshots, IR 53.88 per 100 000 person year; explosions, IR 36.84 per 100 000 person year) were the most affected provinces by the violence-related causes of deaths. The highest IR for road traffic accidents was recorded for Thiqar (IR 11.44 per 100 000 person year).

Violence (gunshots and explosions) in the year 2007 is the highest cause of injury-related mortality in Iraq. Karkuk and Diala were the provinces with the highest violence-related mortality. Age (15–44) was affected most by the violence-related mortality followed by the age group 45–64; gunshots contributed more than explosions. In all of the provinces and in Iraq as whole, males lost their lives more than females due to violence.
Primary healthcare reform in Momtenegro and its influence on rights of patients suffering from mental disorders
Authors: Macic A , Stjepcevic A
Published: March 2011

The aim of the study is to determine the influence of current reforms in Montenegro on the level of protection of patients suffering from mental disorders. Currently two reforms of Public Health System are in progress in Montenegro. The first started in 2005 under the sponsorship of the UN refers to establishment of communal psychiatry, promotion of Mental Health Centers as the reform executors and to improvement of healthcare for patients suffering from mental disorders. The second started in 2007 refers to introduction of a chosen doctor as the executor of the primary healthcare, which diminished the role of mental health centres considerably. The research has been carried out both in the Mental Health Center and in the Health Center of Kotor. It points to interrelationship of the two programs, stating the problems in their application, their results, whether and in which way they imperil the rights of patients with mental disorders and finally it suggests the measures for their outcome. The research shows that there is a collision in essential issues between the two programs, lack of coordination and the fact that the application of this Primary Health Reform reduces remarkably the rights of patients who suffer from mental disorders.
Understanding and strengthening the role of EAPs in addressing intimate partner violence: lessons from EAP providers
Authors: Pollack Keshia M , Clinton-Sherrod Monique , Lindquist Christine , McKay Tasseli , Lasater Beth , Grisso Jeane Ann
Published: March 2011

Given the widespread impact of intimate partner violence (IPV) on the workplace it is critical to understand the involvement of Employee Assistance Programs (EAPs) in workplace-focused IPV activities. A cross-sectional design was employed to obtain information from a diverse set of EAPs, with detailed information about the types of services being offered to address IPV among employees served. EAPs were identified from various sources, including national EAP organisations, an advisory group to the larger grant, individual EAPs and other organisations and individuals who work or conduct research with data was collected from publicly available information and through semistructured telephone interviews with key informants from each EAP.

EAPs

A total of 28 EAPs were identified and information about how EAPs assist workplaces, IPV victims and perpetrators was collected. We found that the IPV services available to employers and employees are extensive and primarily include assistance with policy development, delivery of trainings and seminars, delivery of educational/awareness-raising activities and provision of management/security staff consultation. Yet companies lack of awareness regarding the role of IPV as a workplace issue challenges the ability of EAPs to deliver extensive workplace-based IPV services. EAP representatives also reported challenges in identifying IPV victims, since standardised procedures to do so were limited. Findings from this research provide clear evidence that most EAPs are providing both general prevention activities in the workplace and individual employee services for IPV although these services range from limited to fairly comprehensive.
Domestic violence among women attending the Forensic Medicine Institute Marcala, Department of La Paz, Honduras, June 2007 to November 2009
Authors: Lopez E E
Published: March 2011

Background

In Honduras in 2008 were made 6.572 domestic violence complaints. At the Marcala Forensic Medicine Institute (IML), the leading injury cause complaint by women is domestic violence; the IML covers 10 municipalities, 57 833 women (51%). No previous studies, being necessary to determine the domestic violence prevalence, epidemiological characterisation, injury types and identify the aggressor–victim relationship.

Materials and Methods

A series of cases, defined case: Any woman attended by Marcala IML, physical, mental or sexual domestic violence victim, on June 11th 2007 to November 30th, 2009. All medical records in IML were reviewed, developed a sheet to collect variables data: age, origin, marital status, educational level, profession or occupation, race, type of violence, injury, instrument of injury, disability granted, sequels, relationship with the perpetrator; calculated central tendency and frequency measures.

Results

Reviewed 613 records, 346 met definition case, median 21 years (range 5 to 71), most affected group 20 to 60 years (51.6%), incomplete primary education (33.5%), single (61%), rural area (71.3%) and housework (64%). Observed two violence types: physical (63%) and sexual (37%). Predominated Contusions (57%) and rape (37%). The spouse was the primary aggressor (20%). Municipalities with higher prevalence rates were Marcala and San Jose with 11.6 and 8.7 per thousand, respectively. Only effect observed: pregnancy (12), 18% victims of rape.

Conclusions

Domestic violence present higher proportion on less educated, single women. As a limiting, are recorded only women who be attended by IML. We recommend implementing injury surveillance at other institutions, and disseminate results to other organisation to implement control measures and prevention.
Trends in motor vehicle crash mortality in a small island developing state – the case of Dominica, 2000–2009
Authors: Ricketts P , Bergeron M , Emmanuel R , Smith M
Published: March 2011

The Commonwealth of Dominica is a small island developing state with a population of approximately 70 000 people. There is a significant concern in Dominica over the rise in injuries and violence in the country. Mortality due to motor vehicular accidents is now among the 10 major causes of death (Ministry of Health, 2007). Violence and injuries have become a huge burden on the state and society throughout the Caribbean. Homicide and motor vehicle accidents account for 9.3% of the years of productive life lost in the region, and the second in impact only to HIV/AIDS (CARICOM Secretariat, 2007). In comparison to the attention given to HIV/AIDS and Chronic Non-communicable diseases such as diabetes, hypertension and cancer, inadequate attention is being paid to motor vehicular accidents and other types of violence and injuries generally. The cost of injuries and violence was estimated to amount to 0.7% of Jamaica's GDP in 2002. The trend is similar in all Caribbean countries (CARICOM Secretariat, 2007). Dominica, a CARICOM member state, reveals a road crash death of 4.29 per 100 000 persons. This poster seeks to highlight the importance of motor vehicle crashes as a cause of death in a small island developing state, and the need for targeted interventions to address the problem.
Ethnic differences in injuries in children and youth in Macedonia
Authors: Kasapinov B , Tozija F , Gudeva-Nikovska D , Gjorgjev D
Published: March 2011

The community-based survey was conducted at national level, based on a national estimate of injury prevalence, administered by the Department for injury and violence control and prevention within the National Institute of Public Health. The objective of this paper was to determine the magnitude, scope and characteristics of injuries in children, adolescents and youths from different ethnic background in the Republic of Macedonia at national and community level. Standard methodology was applied as recommended in the WHO Guideline for community-based survey on injuries and violence. Total of 1577 children and youths aged 0–24 have been examined. The survey has recorded injury rate of 6087,5/100 000. Ethnic Albanians were 1.68 times more likely than ethnic Macedonians to sustain injury significantly more injured in the afternoon hours. The most common place of injury in ethnic Albanians was their home, while ethnic Macedonians were most likely to be injured in traffic accidents. Ethnic Macedonians were most likely to be injured during paid and sporting activities while ethnic Albanians were most likely to be injured during unspecified and leisure activities. The most common mechanism for injury in ethnic Macedonians were falls, while ethnic Albanians were most likely to be intentionally injured by other person. Community injury survey has provided more comprehensive data on injuries and violence than data collected through hospital and out-patient based surveillance system. Information obtained is intended to be used for decision-making and conducting preventive activities towards most at-risk population.
Seat belt usage pattern in a developing country: Sri Lanka, which is about to implement new regulations
Authors: Rajapaksha R W M A L , Kumbukgolle K G V , Dharmaratne S D
Published: March 2011

Background

Road Traffic Accidents (RTAs) account for more than 1500 mortalities every year in Sri Lanka (SL). Although pedestrian fatalities have decreased, a recent increase in driver and passenger fatalities has been observed. The SL jurisdiction is exploring the possibility of implementing legislations to necessitate the use of seat belts.

Methodology

This is a cross sectional observational study carried out in Kandy, the second capital of SL. Vehicles entering the city from all the major entrances from 06:00 to 12:00 h were surveyed. The observations were recorded by two independent observers and analysed using SPSS version 13.

Results

A total of 20 066 Vehicles were included in the study. The overall prevalence of seatbelt use is 10.87%. The vehicle type significantly (p<0.001) affected seatbelt use, with highest prevalence seen in passengers in cars (17.62%) and lowest in vans (1.84%). Seatbelt use was significantly high during rush hours (p<0.05). Statistically there was an influence on the usage of SB by one front seat passenger on the other (p<0.001).

Discussion

When compared to developed countries seatbelt use is minimal in SL. Thus seatbelt use needs to be made more popular. More research is needed to identify patterns of seatbelt use and to determine what makes people not to use seatbelts. We suggest implementation of new legislations as well as launching public awareness programs.
Integrated surveillance systems of road traffic and home injuries in the Lazio region, Italy: results of a 5-year study (2001–2005)
Authors: Farchi S , Camilloni L , Chini F , Rossi P Giorgi , Di Lallo D , Guasticchi G , Borgia P
Published: March 2011

Background

Road Traffic Injuries (RTI) and Home Injuries (HI) represent a relevant public health problem. In the Lazio region of Italy a surveillance system was activated.

Objective

To describe the surveillance system and report the health information in terms of temporal trends for the 5-year period 2001–2005.

Methods

We identified all Emergency Department (ED) visits and then linked them with hospital discharges and mortality registry. From the integrated database, we calculated the rates of ED visits, of hospital admissions, and of mortality, reporting the temporal trends.

Results

The 5-year surveillance showed a rate of 3151/100 000 for RTI ED visit and of 2976/100 000 for HI ED visit. The 15–29 year old was the group with the highest incidence of RTI ED visit and hospitalisation rate, 6845 and 493 per 100 000 inhabitants respectively; while the highest HI ED visit rate was in 0–4 years old (5958/100 000) and in older persons (3131/100 000) subjects. During the study period RTI and HI ED visit and hospitalisation rate showed a decreasing trend. The RTI surveillance revealed a decreasing trend for hospital admissions, and a decline of fatal cases from 2003, when the drivers license point system began. It identified higher number of fatal cases (22% more) than the official statistics. The HI surveillance revealed a significant increasing trend in more severe cases, and a stable trend for mortalities.

Conclusion

This study underlines the usefulness of the surveillance in order to monitor temporal trends and effectiveness of preventive measures.
Suicide: an increasing phenomenon in Albania
Authors: Amursi E , Qirjako G , Ndrio M , Nelaj E , Anaku D , Toi E , Lakrori J
Published: March 2011

The incidence of suicide in Albania is increasing from 1 year to the other. According to the statistics of the State Police there were 146 suicides in the year 2000 and 215 suicides in the year 2007. In the year 2008 the number arrived in 331 suicides in a year. The most affected ages are 16–45 years old. The method most used is self poisoning from pesticides. They are sold freely and can be purchased by anyone, despite this is forbidden by the law. The data about the suicides are problematic. They are very little detailed on the issues, differ from one institution to another and there is little access on them. The lack of the data creates a barrier for the prevention programs. The suicide cases are reported regularly on the media. The National Institute of Public Health has produced booklets and trained reporters about a responsible reporting of the cases in order to reduce the imitation, but they are generally not respected. The interventions made in order to prevent suicide are not coordinated as in Albania is missing a national strategy on suicide prevention. As a conclusion, there is an immediate need to create a unified database of the tentative and realised suicide, to have more research on the field and to draw a national strategy on suicide prevention. The Institute of Public Health is working in these directions.
Beyond the neglect of psychological consequences: posttraumatic stress disorder increases the non-fatal burden of injury by more than 50%
Authors: Haagsma J A , Polinder S , Toet H , Panneman M , Havelaar A H , Bonsel G J , van Beeck E F
Published: March 2011

Introduction

Psychological consequences such as post-traumatic stress disorder (PTSD) are currently neglected in burden of injury calculations. The aim of this study was to assess the disease burden of PTSD due to unintentional injury and compare this with health loss to physical injury consequences.

Methods

From literature sources, the prevalence rate of PTSD at four follow-up periods (<3 months, 3–6 months, 7–12 months and >12 months) was estimated. The uncertainty of the estimated PTSD prevalence rate was modelled by using a Bayesian approach. The prevalence rates were then linked to national data on unintentional injury, disability weights and duration to estimate the incidence and Disability Adjusted Life Years (DALY) resulting from PTSD in addition to physical injury consequences.

Results

The data suggest that PTSD prevalence rate among injury victims decreases over time. The average PTSD prevalence rate at <3 months follow-up was 21% for patients presenting at the ED and 30% for patients that were hospitalised, after 12 months tapering down to 4% and 6% respectively. These estimates translate into 191 000 cases of PTSD per year in the Dutch population (1.2%) due to unintentional injury. Including PTSD increases the non-fatal burden of disease of unintentional injuries by 53% from 116 000 to 178 000 DALYs.

Conclusions

Ignoring PTSD in burden of injury studies results in a considerable underestimation of the burden of injury. This may impact resource allocation and the identification of important prevention priorities.
Influence and process of perceived school multiculturalism in relation to youth delinquency and depression
Authors: Le T N , Johansen S , Wallen J
Published: March 2011

From a youth developmental perspective, multiculturalism entails the development of empathetic understanding, intercultural sensitivity, intercultural competence and civic mindfulness (Endicott, Bock & Narvaez, 2003; Bennett, 1993; Cushner, 2008). While studies have examined multiculturalism with respect to academics (Chushner, 2008; Straffon 2003), few studies to date have explored the relation between perceived school multiculturalism and depression and delinquency. This study explores the relation between perceived school multiculturalism and two important youth outcomes, depression and delinquency. Potential mediators including civic engagement, ethno-cultural empathy, ethnic identity and positive peers were also explored as potential explanatory processes of this link.

Results

Results revealed support for a full mediation model in which perceived school multiculturalism was positively associated with civic engagement, positive peers and ethnic identity; civic engagement and positive peers, in turn, were significantly negatively associated with delinquency but not depression. As recommended by Preacher and Hayes (2008), bootstrapping analyses were conducted to assess the effects of mediators by constructing confidence intervals around the estimates. The results portray that only civic engagement was a significant mediator between multiculturalism and delinquency.

Conclusions

The results of this study reveal that there are potentially different pathways and mechanisms by which multiculturalism operates with respect to different youth outcomes. For delinquency, peer factors and sense of belonging seem to be more influential factors than the ability to tune in to the feelings and experiences of others, whereas such ability is more salient for the positive side of emotional health.
Risky neighbourhoods or structural flaws?
Authors: Reinprecht C , Datler G , Keckeis C , Kurtev A
Published: March 2011

Since the 1980s, demographic and structural developments have transformed the social dynamics in European cities. Particularly in poorer communities, such changes may increase feelings of insecurity that facilitate social tension and violence. This study investigated several types of change with regard to their impact on local communities, namely: the current generation change in housing estates built in the 1950s and 1960s; spatial planning decisions surrounding new estates and redevelopments; and new forms of migration, such as the influx of new ethnicities. Eight neighbourhoods in Vienna, Austria, were explored using observations and interviewing. In the analysis, a concept of complex insecurity as the intersection of safety and uncertainty was employed to interpret the neighbourhoods' history, built environment, the interplay between social groups, and processes of stigmatisation. Feelings of insecurity were primarily linked to age and ethnicity, and found on all study sites. Certain groups were perceived more often as threatening or unpleasant, especially young persons and recent migrants. The analysis distinguished between perceived and actual causes of latent conflicts. Respondents complained about noise, dirt, lack of adherence to rules and territorial occupancy. In actuality, the study found that environmental factors, such as lack of spaces designated for young people, the generation gap, expressing itself in different lifestyle preferences, as well as the common scepticism between established and outsiders (Elias/Scotson 1965) accounted for the tensions. Practical recommendations for safer communities call for a multifaceted approach, including flexible spaces corresponding with residents' needs and increased local self-administration.
Interpersonal violence in Europe: markers of prevalence and effective prevention programmes
Authors: Minicuci N , Andreotti A , Rigby M , Alexander D , Vincenten J , Bellis M , Perkins C , Hughes K , Perttu S , Saavola T , Geldschlger H , Zurrilla M , Tabacchi G , Trendafilova P , Penhale B , Lamura G , Lowenstein A , Melchiorre M G , Lindner S N Gage , Sethi D , Mirandola M , Kisser R , Rogmans W
Published: March 2011

In the WHO European Region, 73 000 people were killed by interpersonal violence in 2002, and homicide represents the third leading cause of death after road traffic and suicide. Information on deaths is relatively easy to collect but these are just the tip of the iceberg: psychological, physical, sexual damage and neglect are not captured by routine data. To address this, the general objectives of the PHASE (Public Health Actions for a Safer Europe) project are to enhance injury data exchange in the Member States and to reinforce current health-sector related networks; in particular WP 6 addresses the theme of interpersonal violence. Four focus intervention areas have been identified: child, youth, intimate partners and elderly and four teams of European experts in collaboration with WHO National Focal Points on injury and violence prevention have identified and collected information on: (a) Country profile indicators; (b) Markers of prevalence; (c) Characteristics of violent behaviour; (d) National strategies, prevention programmes and services; (e) Legislation; (f) Reporting Systems; (g) Cost Analysis in the 27 European member states. These domains aimed to describe the magnitude of violence, understand which factors increase the risk for violent victimisation and perpetration, identify which type of programmes are effective and how legislation acts in this respect. The presentation will focus on the methodology adopted; discuss gaps and deficiencies in available information; present epidemiological findings and meta-analysis results. Intervention programmes and strategies that have been implemented and shown effectiveness in preventing violence will also be presented.
Advocating for safer products in Canada
Authors: Fuselli P
Published: March 2011

Injuries to children from use of consumer products are common, frequently serious & sometimes fatal. Survey results show that the vast majority of Canadians believe that if a product is available for sale on the market, it is safe or has been adequately tested for safety. In Canada, this is not necessarily the case since many products, including substandard imports, can pose a dangerous risk of injury. In Canada, there are more than 18 000 annual emergency room visits for children as a result of product related injuries. Canada's current consumer product safety legislation is over 40 years old. Bill C-6, the proposed new Canadian consumer product safety legislation, is a positive step that includes three main pillars; active prevention, targeted oversight & rapid response to enforce mandatory recall of hazardous products. Changes to current legislation would renew, enhance & modernise consumer product safety in Canada to better reflect the globalise marketplace and be consistent with societal & consumer expectations for health and safety. The United States recently renewed product safety legislation with The Consumer Product Safety Improvement Act 2008. The US Consumer Product Safety Commission is currently working with industry on effective implementation. Safe Kids Canada has worked to support the passage of Bill C-6 while industry & special interest groups have strenuously lobbied government & the Senate for amendments that weaken the proposed legislation. This presentation will review experiences, successes and challenges in Canada & the United States in advocating & implementing for safer consumer products through renewed legislation.
The Barell matrix scope of use
Authors: Aharonson-Daniel L
Published: March 2011

Introduction

The Barell matrix proposes a format for epidemiological reports using ICD-9-CM codes. One matrix dimension denotes the body region and the other indicates the nature of injury. The matrix enabled the easy and standard recording and identification of all injuries to a certain body region. It also provides the basis for building multiple injury profiles. After a decade of matrix use, this review examines the literature for applications of the Barell Matrix since its' publication with two aims in mind:

To broaden the exposure of the injury community to this important tool and

To demonstrate the broad scope of potential use for injury statistics using this tool.

Methods

“Pubmed” and “Google scholar” were searched for the terms “Barell Matrix” “Barell body region by injury nature diagnosis matrix” and “Barell injury diagnosis matrix”. Several characteristics for each manuscript were recorded and entered into an excel worksheet. All articles were thoroughly studied to form the following review.

Results

96 applications were included 67.7% from peer reviewed journals, 28.1% non peer reviewed, most in formal government publications. The reports originated in 12 countries in five continents written in four languages. The number of annual publications grew from 3 in 2002 to 19 in 2007. 76 applications are cited and discussed under various headings such as epidemiology, methodology, health economics, public health agencies and more.

Conclusions

The Barell Matrix is increasingly gaining popularity as a tool for standardised injury epidemiology. The broader dissemination of this approach will help boost its' use for the betterment of injury data worldwide.
Paediatric mobility aid-related injuries treated in US emergency departments from 1991 to 2008
Authors: Barnard A M , Nelson N G , Xiang H , McKenzie L B
Published: March 2011

Although mobility aids such as crutches, walkers and wheelchairs are typically beneficial, they can be associated with injury. The objective was to describe the incidence, patterns and trends of mobility aid-related injuries to children and adolescents who were aged ≤19 years and treated in US emergency departments from 1991 to 2008. A retrospective analysis was conducted by using data from the National Electronic Injury Surveillance System database. Sample weights were used to calculate national estimates of mobility aid-related injuries on the basis of 2301 actual cases. An estimated 63 309 cases of children and adolescents who were aged ≤19 years were treated in US emergency departments for mobility aid-related injuries. Approximately 70% of mobility aid-related injuries occurred while patients were using wheelchairs. Children who were aged 2 to 10 years were more likely to sustain injuries while using walkers and wheelchairs, injure their heads and sustain traumatic brain injuries. Children who were aged 11 to 19 years were more likely to sustain injuries while using crutches, injure their lower extremities and sustain sprains and strains. Injuries involving wheelchairs were more likely to be traumatic brain injuries and result in hospitalisation. Injuries involving crutches were more likely to involve misuse and be triggered by stairs or curbs. Injuries related to crutches, walkers and wheelchairs have distinct patterns, mechanisms of injury, and trigger factors. Injury patterns between younger and older children were different. Additional research is needed to identify effective injury prevention strategies for the paediatric population.
Valid measurement of isolation pool fencing: a methodologic challenge
Authors: Girasek D C
Published: March 2011

Valid Measurement of Isolation Pool Fencing: a methodological Challenge Drowning has been identified as the leading cause of death for children under 5 years of age in many areas with hot climates and residents from upper socioeconomic strata. Isolation pool fencing has been documented to reduce the risk of toddler drowning by 83%, when compared to perimeter or three sided fencing (Cochrane Database of Systematic Reviews, 2006). Valid measurement of this proven drowning countermeasure is essential for risk assessment, and for evaluating the effectiveness of educational and legislative interventions. This presentation will draw from the authors experience trying to measure the adequacy of residential pool fencing as part of a randomised controlled trial she conducted in south Florida. Topics to be covered include survey item wording, techniques for minimising misclassification, timing of assessment, the continuum of compliance, and ambiguous outcomes. She will discuss the challenges she encountered, and provide advice for translational researchers who seek to measure this important environmental factor. Many of her insights are relevant to the measurement of other child safety outcomes.
Impact of safety promotion and enforcement of traffic legislations on road users in Mauritius, 1999–2009
Authors: Panchoo S
Published: March 2011

Sustained Safety Promotion/Education campaigns among road users and the enforcement of traffic regulations over a period of 20 years have paid dividends in reducing the fatal accidents from 170 in 1999 to 129 in 2009 and the number of fatalities from 170 to 140 during the same period, despite the fact that the number of vehicles has considerably increased during these 11 years. Aggressive road safety promotion campaigns have been conducted during these 11 years by the Ministry of Public Infrastructure, Land Transport & Shipping, the Road Safety Unit of the Mauritius Police Force and other stakeholders on the use of seat belts and helmets, speeding, drink & drive and safe behaviour on roads targeting pedestrians, drivers and two wheelers, among others. Moreover, the introduction of the Breath Test/Ethylotest in September 2003 and the speed cameras in December 2008 have played a key role in lowering this number. The number of contraventions established for speeding, non use of seat belts and defective vehicles etc has been on constant rise over the years. Only with the introduction of the mobile speed cameras in 2008, 30 000 contraventions have been established. All these measures have to some extent contributed to bring a change in the behaviour of road users who share the same space with high-speed motorised traffic. Better results may be obtained if there is sustainability in the road safety promotion campaigns and in the enforcement of traffic legislations and provision of segregated road space between non-motorised and motorised traffic.
The impact of 20 mph speed zones on socio-economic inequalities in road casualties in London
Authors: Steinbach R , Grundy C , Edwards P , Wilkinson P , Armstrong B , Green J
Published: March 2011

While socio-economic inequalities in road casualty risk are well documented, there is little evidence available on what works to reduce them. As there is good evidence that reducing the speed and volume of traffic reduces casualty rates, some have suggested that implementing traffic calming, and doing so particularly in areas where there are high rates of deprivation, might reduce not only overall casualty rates, but also area level inequalities in casualties. However, there have been few studies that have tested this suggestion empirically. 20 mph zones are a type of area wide traffic calming that use engineering measures to physically reduce traffic speeds. Recent research has shown these zones to be very effective in reducing injuries. We examined the impact that 20 mph zones have had on socio-economic injury differentials in London. Over the last two decades, London has implemented 400 20 mph zones, including 235 targeted at areas of high deprivation. Using 20 years of road injury data, we estimate that the implementation of 20 mph zones has reduced the relative difference in the number of casualties between the most deprived and least deprived areas of London by 15%. However the potential of 20 mph zones to contribute to future reductions in injury inequalities is limited. Extending 20 mph schemes to all areas where it is cost-effective to implement them would reduce differentials by a further 1%.
Years of safe community activities in Dallas, TX, USA: has it made a 15 difference?
Authors: Stephens-Stidham S , Stowe M , McCoy M , Anderson R , Boumbulian P , Istre G R
Published: March 2011

Background

The Injury Prevention Center of Greater Dallas, Texas (IPC) was established in 1994, and Dallas became the first WHO designated Safe Community in the U.S. in 1996. The IPC has used the Safe Communities model approach, has worked with >100 different organisations and agencies, and has promoted coalitions and community groups that are engaged in injury prevention. The IPC has devoted much of its effort toward prevention of Motor Vehicle Crash (MVC) and Residential Fire-related deaths and injuries in Dallas County.

Methods

We compared the change in deaths rates (per 100 000 pop.) from vital statistics between 1994–96 and 2004–06, for MVC deaths and Fire-related deaths. Dallas County rates were compared to rates in Harris County (Houston) and Bexar County (San Antonio), the primary counties for the two other largest metro areas in Texas.

Results

MVC Death rates in Dallas County decreased from 16.1 to 13.1 (down 18%) between 1994–96 and 2004–06 (p<0.05), and Fire-related death rates decreased by 48% (p<0.05), both of which were greater than either Harris or Bexar counties, the state of Texas as a whole, or the U.S. as a whole.

Conclusion

Secular trend evidence indicates that MVC and Fire-Related deaths have declined substantially during the time of a Safe Communities Model effort in Dallas County, which focused on those areas. While we recognise that secular trend comparisons do not prove effectiveness, the results are consistent with a beneficial impact of the Safe Communities program in Dallas.
School injury in Israel: findings from Magen David Adom
Authors: Molcho M , Yafe E
Published: March 2011

Background

Data on school injury are not always easy to obtain. Many of the existing data are based on schoolchildren's self-report. Self-reported data are vulnerable to recall bias, and to interpretation of what is considered as medical treatment, a term usually used as a criterion to prevent children from reporting insignificant injuries. In Israel, all data on school-related injury were collected using self-reported questionnaires. In the academic year of 2007/08, Magen David Adom (MDA), a NGO that provides first aid and ambulance services in Israel, provided first aid services to all schools in the state. This paper presents findings from these data and compares them to previously published self-reported data collected by the Health Behaviour in School Aged Children survey.

Methodology

During the 2007/08 academic year, MDA had set a call centre for schools. In case of a school injury, schools were encouraged to call the centre for telephone assessment followed by either: advice on treatment at school by school staff; provision of first aid by member of MDA staff on school grounds; or provision of an ambulance service. The service was offered free of charge to all the schools in the state. MDA staff recorded all calls, and collected information on the type of injury, location and time for all types of services.

Main Findings

The paper will present analysis of the data collected and will compare prevalence to nationally representative sample of self-reported injury in school going children.
A self critique of a decade of injury research by the Injury Control Center Uganda (ICCU)
Authors: Wandera B , Nakiito M , Lett R
Published: March 2011

Background

The ICCU has been doing injury research, advocacy and training for the last 12 years. Here we provide a review of their findings to provide coherent information and identify priorities areas to tackle.

Methods

All original research published between 1999 and 2009 were obtained from the centres records and reviewed.

Results

Of the 32 research publications, 15 were original research. The majority were cross sectional (13), while two were longitudinal studies. The burden of injuries in Uganda is 11–15% of the population annually. Road traffic injuries (RTI) contribute 35–50% of all injuries and are the leading cause of injury death among adults although drowning is the leading cause among communities near water bodies, while falls, burns and RTI are the leading causes of injury deaths among children. The Kampala trauma score, with a better utility, was developed and tested for use as a triage tool a grading injury severity. Only $0.09 per capita of government expenditure is put on road safety and emergency and ambulance capacity is very poor. Despite few personnel, trauma team training of emergency medical personnel was done to improve efficiency. Community acceptance of some interventions, like a pedestrian overpass to reduce RTI was low.

Conclusion

A lot has been studied about injury in Uganda, however, risk analysis and innovative, injury prevention interventions/management and disability prevention research is needed. A Multi-sectoral approach, increased funding including community participation is needed especially in Road traffic and drowning injury prevention.
Level of undertriage in a well established Trauma Registry in Denmark
Authors: Haug A K , Wilson T , Larsen M S , Lauritsen J M
Published: March 2011

Background

Triage is the correct admission of injured patients to a suitable treatment level. Previously no studies were done for the trauma registry at Odense University Hospital (OUH) in Denmark established in 1996. Aim was to assess level and character of undertriage.

Method

Retrospective analysis of data collected from OUHs list of patients admitted with ICD S- and T-diagnoses in 2007. Inclusion criteria is ISS>15, treated in intensive care >2 days, dead within 30 days, or proximal penetrating injury. Over-triage was identified on the basis of the trauma registry for patients received by the trauma team, where the severely injured patient was defined as ISS>15 or proximal penetrating injury. In total 747 trauma patients were received in 2007, 21% with ISS>15.

Results

Undertriage including death within 30 days was 22%, without these, 11%. Women had a higher risk of undertriage than men, and undertriaged patients were significantly older than correctly triaged patients. We discovered a high frequency of falls from low heights in undertriaged patients. 628 patients were admitted by the trauma team, with an over-triage of 82%.

Conclusion

We found an undertriage proportion comparable to similar studies. Elderly patients and women had a higher risk of being undertriaged, which also has been shown in other studies. We believe further research should be concentrated on the reasons for the high under and over-triage, by investigating current systems and routines, and to research whether the elderly and comorbid would reap benefit from medical participation in early treatment.
Childhood unintentional injuries surveillance in Ismailia governorate, Egypt
Authors: El-Sayed H , Hyder A , Zekry O , Sugerman D , Abdel-Hamid S , Abbas H , Puvanachandra P
Published: March 2011

Objective

To determine the epidemiology and risk factors of childhood injuries in Ismailia governorate Egypt.

Methods

This is the Egyptian chapter of the Global Childhood Unintentional Injury Surveillance study, which employed quota sampling of children 0–11 years old presenting to the Emergency Department. This surveillance was conducted in the University Hospital of Suez Canal University Egypt, for selected months in 2007. Children with an unintentional injury of both genders were enrolled in the study.

Results

Out of a total of 551 cases, 361 were males (66%) and 478 (34%) females. The most common external causes of injuries were falls (60%), road traffic injuries (15%), burns (7%), poisoning (3%) and near drowning/drowning (2%). The most common sustained injuries were fractures (17%), cuts or open wounds (15%), sprains (14%) and burns (9%). The majority of patients were treated and discharged home without disability (67%), while 7.8% had long-term temporary disability that lasted for more than 6 weeks and more than 1% sustained permanent disability. There were five deaths (1% proportionate mortality), all were due to falls. Few families recounted using seatbelts (2%), car air bags (0.5%), helmets (1%), child restraint seats (1%). The majority of children received care via government insurance.

Conclusions

The burden of childhood injuries on the university hospital in Egypt is substantial. Ongoing child injury surveillance using systematic approaches is required to identify the epidemiology of injuries, their risk factors and plan for timely interventions.
Perception of community and school safety by senior in-school youths of a secondary school in Ibadan, Nigeria
Authors: Adebiyi A O , Akinyemi O , Sangowawa A O
Published: March 2011

Introduction

In an unsafe environment, youths are denied the opportunity to develop psychosocially, and intellectually. This study sought to find out the perception of senior in-school youths about community and school safety.

Methodology

Cross sectional study of senior in-school youths was carried out using a total sample of consenting students. A self administered questionnaire was used to elicit information on socio-demographic characteristics, perception of and characteristics of safe communities and schools.

Results

The mean age of respondents was 16.41.6 years and 54.7% were females. Majority (62.4%) live in densely populated area. Only 182 (50.0%) perceived their school to be safe, 154 (42.3%) perceived it to be unsafe and 28 (7.7%) couldn't make up their minds. However, 265 (72.8%) reported their communities as safe, 66 (18.1%) as unsafe and 33 (9.1%) had no opinion. The most important perceived feature of a safe community mentioned was security 209 (57.4%) and 22.5% of youths have ever been molested. Within 6 months preceding study, 50 (13.7%) had felt unsafe and those reporting incidents like rape, street robbery, drug use and youth gangs as occurrences in their communities were 111 (30.5%), 127 (34.9%), 167 (45.9%), 151 (41.5%) respectively. Street lights, Zebra crossings and side-walks were absent in 81%, 83.8% and 56.9% of the communities respectively.

Conclusion

More youths perceived their schools to be unsafe. The prevalence of drug use and youth gangs was quite high in neighbourhoods. Further researches on school safety are desirable while governments and communities should begin to collaborate on safety issues.
Qualitative assessments of injury prevention strategies among newcomers to Canada
Authors: Hossain N M , Macpherson A
Published: March 2011

Background Information

Little is known about immigrant children's lifestyles and the uptake of strategies to prevent unintentional injuries. Being an immigrant to Canada can be a risk factor for a child's health because of the cultural differences in the uptake of healthy activities between their country of origin and North America.

Objectives

To determine the barriers and enablers related to injury prevention strategies such as car seats, bicycle helmet use and participation in formal or informal physical activities.

Study Participants

Twenty parents from two language groups; Bengali and Spanish, who arrived in Canada within the past 2 years, participated in this study. Participants were recruited with the help of immigrant and settlement organisations.

Data Analysis

The focus groups were each 2 h and were transcribed and translated into English. Data were analysed using thematic content analysis, which explores emerging themes from interview or focus group data.

Result

Parents expressed a need for more immigrant friendly injury prevention information. Such information has to be linguistically correct and culturally appropriate for the specific immigrant group. Inadequate information regarding injury prevention and a sense of feeling blamed when their child got hurt were important themes for both groups.

Conclusion

Immigrant parents want to follow Canadian guidelines for injury prevention, but often do not understand the Canadian cultural context. Healthcare professionals should provide important information programs designed specifically for this growing immigrant population.
Electronic-media harassment among secondary school adolescents in Ibadan municipality Nigeria: myth or reality?
Authors: Sangowawa A O , Adebiyi A O
Published: March 2011

This pilot was conducted to determine the incidence and forms of electronic-media harassment among secondary school students. Students who owned a mobile phone and had access to the Internet were selected via multi-stage sampling. History of harassment in the 3-month period preceding the study was obtained.

Results

A total of 129 students- 65(52.4%) boys and 59(47.6%) girls with mean age of 13.9(±1.9) years participated. Eighty-four(66.1%) were from private and 43(33.9%) government-owned schools; 65(51.2%) were in junior and 62(48.8%) in senior classes; 88.2% lived with both parents. All respondents had personal phones and 66(52.0%) had access to the Internet. Forty-three (33.9%) had suffered electronic harassment while 19(15.0%) had harassed others. Twenty-four (18.9%) were victims only, all 19(15%) perpetrators were also victims. The commonest modes of harassment were text messages 31(24.4%) and phone calls 25(19.5%). Of the 66 with Internet access, four each had experienced harassment through email and in chat rooms and two via websites. Twenty-one (16.5%) had harassed others via text messages, 21(16.5%) through phone calls and 6(4.7%) through picture or video clips. Perpetrators were mainly boys. The incident was often reported to friends, parents/guardians, other adults in school, class teachers. Factors predictive of being a victim were public schooling(OR 4.9, 95%CI 2.0 to 11.9), and being in a senior class(OR 3.5, 95% CI 1.6 to 8.6).

Conclusion

This pilot revealed that electronic media harassment was occurring among the students. This phenomenon thus needs to be further investigated and efforts put in place to curb it.
Incidence of hip fracture in Parkinson disease: a population-based study in British Columbia, Canada
Authors: Voaklander D C , Martin W , King-Jesso P , Ozegovic D , Jones A , Wieler M
Published: March 2011

Aims

Parkinson's disease (PD) constitutes a significant risk for falls and subsequent hip fracture, yet the rate of hip fracture in this patient population has not been clearly delineated. We looked at the incidence rate of hip fracture in a provincial-based population 65 years or older who had PD.

Methods

To identify PD cases record linkage of inpatient hospitalisation, physician billing and prescription records were examined for PD specific diagnostic codes for British Columbia, Canada. Hip fracture cases were identified using the International Classification of Diseases Version 9 codes. Data for the fiscal years 1991/92 to 2000/2001 were stratified by year, age group, sex. Incidence rates of hip fractures in PD were calculated using prevalent PD cases in year as the denominator.

Results

For females rates of hip fracture were the highest in first years of the study peaking at 31.0/1000 PD case in 1991/92 and dropping to 20.8/1000 in 1999/00. Female's rates were consistently about 1.7 times that of male rates. The male rate of hip fracture peaked in 1993/94 at 19.8/1000 PD cases dropping to 12.6/1000 in 1999/00. Rates increased with age in both sexes.

Conclusions

The PD population appears to be at greater risk (3 to 4 times) of hip fracture when compared to rates reported for the general Canadian population. The differential in rates appears to be most apparent in younger PD (<75 years) cases.