bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of falls and fractures in the elderly living in extreme poverty conditions
Authors: Manrique-Espinoza B , Salinas-Rodriguez A , Tillez-Rojo M M
Published: March 2011

Objective

To estimate the prevalence of fractures and falls from elderly living under poverty conditions in Mexico, as well as to determine associated factors to fractures.

Methods and Materials

A three stages probabilistic survey, stratified by community type (rural or urban) and nationally representative was conducted. The objective population was formed by individuals with 70 years old and more, who are beneficiaries from Oportunidades program.

Results

Mean age was 78.4 years, and 56.5% were women. From the total interviews, 61.2% of the elderly reported not to know how to write or read; being this more prevalent in women than in men (69.7% vs 50.3% respectively). 47.1% of women and 31.7% of men reported had fallen in the last 2 years before the interview. The prevalence of fractures any bone including hip-after 50 years of age was 20.6% for women and 14.2% for men. Having bone diseases (OR 1.41), having osteoporosis (OR 1.73), having at least one difficulty to do daily life basic activities (OR 1.34) and being a woman (OR 1.51) are factors related to fracture presence in elderly.

Conclusion

The necessity of healthcare in elderly is shown due to the high prevalence of falls and fractures.
Next steps in child injury prevention inclusion as a part of child survival
Authors: Scott I , Ozanne-Smith J , Meddings D
Published: March 2011

Introduction

The World Report on Child Injury noted that over 90% of child injury deaths occur where data and health capacity are least and services and planning are swamped with excess demand. The first overarching recommendation was that child injury be integrated into a comprehensive approach to child health and development. A draft resolution on child injury will be considered by The WHO Executive Board in 2010 and will, hopefully, be adopted by the World Health Assembly in 2011. A central argument for the resolution is that child survival patterns have changed significantly and reductions in infectious disease in many places have unmasked child injury burden that was either there all along and is relatively stable (eg, drowning), or was there all along and is increasing (eg, road traffic injury). The question of how current child survival programmes, which are focused on infectious disease, can be reoriented to include injury prevention is fundamental to expanded action on child injury and the focus of this research and consultation.

Method and Discussion

An informal collaboration involving agencies such as UNICEF and WHO and committed individuals will use a quasi-Delphi consultation to identify key questions in establishing child injury prevention as part of efforts on child survival. Iterative electronic consultation will be used with key informants to establish links, collect information and develop ideas on planning and priorities. A special session of the satellite biennial meeting of the International Association for Child and Adolescent Injury Prevention (ISCAIP) will discuss and amplify the results of the internet exchange.

Conclusion

This is intended to (a) foster discussion on the how and what of integrating child injury prevention; (b) engage agencies and individuals and foster discussion, information exchange and collaboration; (c) facilitate identification of productive areas of work and priorities; (d) foster practical action. The results of the consultation will be presented and discussed. After any subsequent amendment they will be made available to all agencies and participants.
Lack of adequate road furniture in Nigeria – consequences and solutions
Authors: Olawepo O
Published: March 2011

Situation reliable reports conducted by the World Bank transport department on the state of roads in Sub Saharan Africa between 1998 and 2008 confirmed a gross inadequacy of road furniture for safety of road users. Specifically, in the West African region, previous credible studies showed that no country with the exception of Ghana took broad steps to install appropriate and near adequate road furniture in 20% of the existing roads. In the past 10 years, the worsening state of Nigerian roads and lack of adequate road furniture have been of concern for road users especially given its attendant threat to lives and safety of road users.

Objective

To investigate the inadequacy of road furniture on Nigeria roads and make recommendations.

Method

Investigation was conducted on three major highways in Abuja, the Federal Capital City of Nigeria, Lagos, the commercial centre and Ilorin, a state capital. Questionnaires were distributed to 10 Federal Road Safety Officials. The existence of road furniture was examined.

Conclusion

The study revealed gross absence of road furniture, 50% of Federal Road Safety officials interviewed in this study suggest that the absence of road furniture in Nigeria is grossly contributing to the high incidence of road traffic crashes. The Federal Road Safety Commission and road development agencies should give this issue a priority and help reverse the trend of absence of road furniture in Nigeria.
Loss-to-follow up factors in emergency department-treated mild traumatic brain injuries
Authors: Hsu P , Kraus J , Afifi A A , Vaca F , Schaffer K
Published: March 2011

Introduction

The number of subjects in a prospective cohort study often decreases over time (sometimes substantially). This “loss-to-followup” can lead to bias or distortion of results, and in studies of less serious conditions or injuries such as mild traumatic brain injuries (MTBI), may be especially problematic. This manuscript reports on the factors associated with the loss-to-followup that occurred in a cohort of emergency department-treated mild traumatic brain injuries, and on the use of attrition weights to adjust for the potential associated bias.

Methods

The “exposed” group consisted of patients with MTBI (n=689 at initial assessment) and the “unexposed” were patients with non-head injuries (n=1318). All were drawn from five emergency departments in Southern California. The loss occurred over a 3-month period, when a second telephone survey was administered.

Results

While the overall loss-to-followup rate was 37.8%, participant dropout occurred differentially (34.1% among MTBI patients vs 39.7% among the non-head-injured). A logistic regression model found several associated factors: age, education, race/ethnicity, employment and mode of injury, with assault having the highest odds of loss-to-followup (OR 2.23, 95% CI 1.46 to 3.39). Comparisons between unweighted versus attrition-weighted values resulted in minimal differences.

Conclusion

Although it is preferable to minimize loss-to-followup through retention strategies and incentives (perhaps with additional focus on those factors identified in this study), employing attrition-weights may provide useful information.
Hangovers and traffic injuries: is alcohol's influence greater than expected?
Authors: Smith G , Dischinger P
Published: March 2011

Elevation of blood alcohol concentration (BAC) is a well-recognised risk factor for MVCs but little is known regarding hangovers and crash risk. We analysed data from multiple sources to determine evidence that hangovers increase injury risk and developed a methodology to determine if hangovers represent a real injury hazard. Examination of trauma patients with negative BACs on admission found 12% met our criteria for current dependence and 24% for lifetime dependence, which is 4–5 times higher than the general population. Experimental hangover studies find significant impairment and reduced task performance after BACs return to zero. However no studies examine actual crash risk, in part because objective data to document hangovers is lacking. Studies of alcohol consumption biomarkers, ethyl glucuronide (EtG) and ethyl sulfate (EtS) suggest they can indicate recent heavy drinking even when blood alcohol is zero. We propose to quantify the role of hangovers in MVCs by assessing these new biomarkers in urine among drivers admitted to our trauma center and deaths from the medical examiner. Case-crossover analyses comparing self-reported drinking 12 h prior to injury with usual drinking patterns will provide one estimate of risk. Culpability studies determining the extent to which injured zero BAC drivers with biomarker evidence of hangover are responsible for causing their crash, compared with drivers without hangover biomarkers will be used as another estimate of risk. This study is an innovative use of biomarkers in injury research and may indicate that hangovers are an important but unrecognised risk factor in many injuries.
Work-related suicide
Authors: Ozanne-Smith J , Routley V
Published: March 2011

Introduction

While unintentional work-related injury is increasingly recognised as an important and preventable public health problem, population studies of the full range of work-related suicide reported to coroners have received less attention.

Objective

To investigate the epidemiology of work-related suicide in Victoria, Australia, July 2000–December 2006

Method

This study draws on a database of all work-related deaths reported to the Victorian Coroner, inclusive of broadly defined work-relatedness. Inclusion criteria for work-related suicide occurring between July 2000 and December 2006 were as follows:

work stressors identified in police reports to the coroner or the coroner's finding; or

suicide method involved another person's work (eg, heavy vehicle); or

suicide location was a workplace; or

means of suicide was work-related; or

deceased working for income at the time of death.

Excluded were as follows:

cases still open for investigation;

commuting to work;

DIY-related.

Results

There were 613 work-related suicides over the study period, compared with 969 unintentional work-related injury fatalities. Of the suicides, 56% directly involved work stressors; 31% jumped or lay in front of a moving train or heavy vehicle; 4% involved work agents; and 9% other. Detailed analyses of work stressor cases identified business difficulties, unemployment/redundancy, recent or previous work injury, and, infrequently, workplace bullying. The complexity of multiple contributing factors will be addressed.

Discussion and Conclusions

Work-related suicide is a substantial problem, for which few detailed population-wide studies are available. Further research is required to understand the contribution of work stressors and effective interventions.
Demographic and circumstantial accounts of burn mortality in Cape Town, South Africa, 2001–2004: an observational register based study
Authors: Van Niekerk A , Laubscher R , Laflamme L
Published: March 2011

Burns are reported to be a persisting public health problem in South Africa. The current study describes the epidemiology of burn mortality across the lifespan in Cape Town (2.9 million inhabitants in 2001), one of the six South African metropolitan centres. The distribution of burn mortality across socio-demographic groups and also their circumstances of occurrence were investigated using 4 year (2001–2004) surveillance data from the National Injury Mortality Surveillance System (n=1024 cases). Burn mortality occurred at a rate of 7.9 per 100 000 person-years (95% CI 7.3 to 8.3), most often among males, with the highest rates in the 25 to 38 year age group (19 per 100 000). The greatest difference between male and female deaths was observed in that age group, when almost three male deaths occurred for every female one. The vast majority of fatal burns were registered as accidental and occurred in the home, either over the cold and wet months or during recreational periods over weekends and across the year. Alcohol intoxication was reported for the majority of those adults whose alcohol blood levels were tested. The high prevalence and circumstances of occurrence of burns among middle age men are a source of concern. There are reasons to believe that this over-representation is a reflection of detrimental living conditions, life-style and poor socio-economic status. It is recommended that prevention activities involve the management of kerosene appliances, alternatives to flammable housing materials, and the implementation of strategies to reduce harmful drinking practices.
Getting your research published: writing forInjury Prevention
Authors: Johnston B , Ameratunga S , Blank D , Kendrick D , Pless B , Winston F
Published: March 2011

Participants will become familiar with the process of writing for scientific publication, including a discussion of common mistakes, useful resources and strategies to improve the writing process and acceptance rates. Topics to be covered include: Why publish? Identifying the research question, How to write a paper, Using reporting guidelines, Finding mentorship, Common issues in publication ethics, Choosing the right journal. Understanding peer review & editorial decision making. Space and attendance permitting, the format will include a didactic presentation followed by small group discussions and exercises facilitated by some of the most highly published researchers and research mentors in the field.
Drive way run over
Authors: Chambers J
Published: March 2011

Driveway run-overs happen when small children are unintentionally driven over and killed or injured, by slow moving vehicles maneuvering on private land. Personal error, vehicle design and the environment (driveway and property design) are all factors thought to contribute. This study investigated what elements of driveway and property design might be important contributors to these tragic events happening. Cases and controls were selected from New Zealand residential properties where child injury had occurred. Analyses were carried out on the features of 88 case properties and 181 control properties. Results showed risk of injury was increased by: a driveway length of greater than 12 m (OR 1.8; 95% CI 1.1 to 3.0), exiting the driveway onto a local road (OR 5.5; 95% CI 2.7 to 11.2) and the driveway exiting onto a cul de sac (OR 2.3; 95% CI 1.4 to 3.9; when more parking areas were on the property (requiring the use of the driveway to access) (OR 3.0; 95% CI 1.6 to 5.4). There was a lower risk when it a walkway or path separate to the driveway was present on the property. The study demonstrates environmental features of a property can affect the likelihood of child driveway run over injury and consideration of these results by the design and building communities is urged.
Youth for road safety: young people mobilising to be part of the solution
Authors: Darroch M , Lieshout F
Published: March 2011

Road traffic accidents take young lives indiscriminately. Every day, over 1000 young people are killed on the world's roads. This issue is a global health concern and is recognised by the WHO as the leading cause of death among 15- to 25-year olds. In many cases, young people are often the cause of the problem; by driving too fast, disregarding road safety measures or taking greater risks as road users. In the face of such problems, young people from around the world have mobilised to address global road safety and have pledged to become part of the solution.

In doing this, youth representatives from around the world have united to form YOURS, first Youth NGO for Road Safety. YOURS represents ‘Youth for Road Safety’, its primary aims are to inspire young people to take change their road behaviour, to advocate for young people and to build real capacity to reduce the amount of young people killed and seriously injured on the roads.

This session comprises discussion on youth engagement in road safety. In particular, it will draw upon official statistics and scientific research that presents the issue in context. The session aims to present concrete solutions to deal with the problem as well as focus on the issue of engaging young people in road safety action. It will be particularly useful for stakeholders in road safety, injury precention and services to young people.

We also wish to propose a Youth Plenary session for this cause.
Epidemiology of rail suicide in Victoria, Australia
Authors: Routely V
Published: March 2011

Rail suicides account for approximately 5.8% of suicides in Victoria and the rate per head of population (0.63 per 100 000) is higher than Australia overall (0.39). Victoria's rail network is largely unfenced and above ground.

Aim

To describe post year 2000 patterns of rail suicide in Victoria.

Method

(1) Transport, medical and psychological library databases were searched for “rail and/or train suicide” and located articles and reports reviewed. (2) Rail industry, Victorian Department of Transport, National Coroners Information System (NCIS), hospital admission and Australian Bureau of Statistics (ABS) databases were interrogated for completed and attempted rail suicides. Variables extracted and analysed included: age, sex, location, time of incident and any previous suicide attempts, mental illness or mental health facility association. Walking distance between residence and suicide location was estimated using Google map and presence of fencing determined using Google map and Streetview. Hotspot areas were determined using a Suicide Priority Scoring System (SPS).

Results

Descriptive statistics will be presented on completed and attempted rail suicides by age, sex, location, difference between residence and suicide location, fencing, temporal and mental health factors. Reported results will also include hot spot areas identified and recommendations for prevention.

Conclusion

The findings of this study support previous research that young males with mental illness, including schizophrenia, are common among rail suicides. Short, medium and long-term recommendations, including additional fencing, were made. There is a need for countermeasures to prevent suicides that occur on the open line and are not concentrated at specific locations.
Developing NICE public health guidance to strengthen strategies and structures to prevent unintentional injuries among children aged 0–14 years
Authors: Ward H , Millward L , Chatterton H , Jagroo J , Crombie H , Shearn P , Ellis S
Published: March 2011

Unintentional injury is a leading cause of death among children and young people. While death rates are falling, in 2008/09 around 97 000 children and young people in England were admitted to hospital due to injuries. The National Institute for Health and Clinical Excellence (NICE) has been asked by the Department of Health to produce a suite of five pieces of public health guidance on the prevention of unintentional injuries to children and young people aged under 15. One focuses on strategic and structural issues around injury prevention and the other four provide guidance on effective and cost-effective interventions on the following:

▶

the provision of safety equipment and home risk assessments,

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road design and modification,

▶

outdoor play and leisure, and education, and

▶

protective equipment to prevent unintentional injuries on the road.

The NICE public health programme guidance in this area covers strategies, legislation, regulation, enforcement, surveillance and workforce development. It draws on the best available evidence, both national and international, of effectiveness and cost effectiveness and is systematic and transparent in the processes and methods used to access and distil the evidence. A group of external technical and lay experts met regularly over a period of nearly 2 years to assess the quality, strength and applicability of the evidence to the English situation and develop recommendations directed at national and local policy makers, strategic planners, commissioners, managers and practitioners with a direct or indirect role in preventing unintentional injuries. Publication of the guidance towards the end of 2010 will give new direction and impetus to all those working in partnership to prevent unintentional injury among children and young people.
Experience of intimate partner violence among rural and urban women in Oyo State, Nigeria
Authors: Balogun M O , Owoaje E T , Fawole O I
Published: March 2011

Background

Intimate Partner Violence is an important public health problem in Nigeria. Previous studies on IPV have focused mainly on physical violence providing little information on the prevalence of the other forms of IPV.

Methodology

This study assessed prevalence of all forms of IPV among women of reproductive age in selected rural and urban communities in Akinyele Local Government Area, Oyo State, Nigeria. A semi-structured interviewer administered questionnaire was used to obtain information on socio-demographic characteristics of the respondents and factors associated with occurrence of IPV.

Result

Three hundred women each in rural and urban areas were interviewed. Mean age was 29.7–8.5 years. Lifetime prevalence of IPV was 67%, controlling behaviour 49.8%, psychological violence 34.7%, physical violence 20.8% and sexual violence 11.6%. Predictors of lifetime experience of any form of IPV were duration of relationship greater than 2 years and quarrelling often with partner. Urban residence, partner's younger age and involvement in physical fights with another man, were predictors of experiencing controlling behaviour. Being ever married and in relationship for over 2 years were predictors of psychological violence. Alcohol consumption by partner, being in relationship for over 2 years, ever been married and rural residence were predictors of physical violence. Predictors of sexual violence were being single and partner's involvement in physical fight with another man.

Conclusion

IPV occurs commonly among women in these communities. Multidisciplinary strategies should be designed and implemented for the prevention and control of different forms of IPV identified.
Working together to make a difference in child injury prevention in Vietnam
Authors: Nguyen A
Published: March 2011

Every day in Viet Nam, injuries takes away the lives of more than 20 children and adolescents (aged 0–19) and mortality represents only the tip of the iceberg in terms of the real burden of injury. It is estimated that for every child injury related death, 12 children are admitted to hospital or permanently disabled and 34 children require medical care or miss school because of injury. UNICEF has been working with the Government of Viet Nam to combat child injuries since 2001 through public awareness raising, policy advocacy and model demonstration. Important achievements have been obtained in this field, contributing to raising awareness of national public, and to advocating policy makers on child injury prevention. Today, child injury is no longer an invisible issue in Viet Nam. However, work in this area is just getting started. Child injury prevention remains a huge challenge in Viet Nam that will require continued commitment of a wide range of partners, sectors and communities under a strong governmental leadership. In the coming years, UNICEF Vietnam will continue to support Vietnamese Government in the following areas:

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Develop a comprehensive plan of action on child injury prevention, which includes legislative, enforcement and environmental changes to support existing education and public awareness campaigns;

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Enhance inter-sectoral coordination of child injury prevention and

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Improve the quality and quantity of data for child injury prevention.
Local area inclusive trauma management for road safety Udonthani municipality, Thailand; 2003–2007
Authors: Sethasathien A , Kommuangpuk D
Published: March 2011

Deaths from road traffic injury (RTI) have always been the top three of Thai. Mortality over 20 per 100 000. Udonthani municipality was also confronted with this problem. In 2003, dead from RTI was up to 53 cases. The most injured persons were male (69.9%), with active age group and top vehicle type was motorcycle (78.3%). The occupations were labours and students (26.5% and 23.4%). But dead cases was decrease from 2003 to 2007 (52, 39, 21, 15 and 4 cases respectively) after inclusive trauma management was applied by the provincial road safety committee. That included Injury surveillance for monitoring, Prevention activities, Emergency Medical Service System, Mass casualty Preparedness and Critical Trauma Care. For prevention, we used 3E strategies (education in labours and student risk group; enforcement on helmet, seatbelt, drunk and speed control; engineering for reconstructing the black spot. From the registry we found that the risks factor in alcohol drunk drived injured, non-helmet and non-seatbelt were decrease year by year (alcohol drinking = 694, 369, 209, 304 and 150 cases; non-helmet = 1290, 641, 392, 396 and 294 cases; non-seatbelt = 31, 12, 6, 5 and 4 cases respectively). For environmental management systems, trends of qualified first aid in four critical procedures including respiratory care, stop bleeding, splint and intravenous fluid were improved from 10% in 2003 to more than 80% in 2007. For improvement of critical trauma care, we had decreased the percentage of dead case with Trauma and Injury Severity Score more than 0.75 in 5 years.
Interventions to support victims of domestic violence: health service responses and a multi-agency model
Authors: Barran D , Feder G
Published: March 2011

Historically healthcare has lagged other sectors in responding effectively to domestic violence, despite its significant public health impact and the view of survivors that they want support from doctors. As part of the UK Department of Health's taskforce on “Responding to violence against women and children” a domestic violence subgroup made recommendations including: Prevention: Healthcare professionals should work in partnership with other sectors in challenging the acceptability of domestic abuse among young people. Identification and management: Clinical teams need training to ensure they use safe enquiry to identify domestic violence and offer appropriate services to their patients. Key services and successful pathways: Commission intervention programmes for women survivors and their children. Services may include community based provision such as independent domestic violence advisers (IDVAs), and specialist support services for children and young people. Integration of psychological support and treatment for survivors and their children into mainstream primary and secondary healthcare. Improving availability of and access to services: Provide national guidance on commissioning of specialist domestic violence services for women and children that can be accessed from primary care, women's health and emergency health settings. Information sharing: Integrate child protection and domestic violence information sharing, to create a two-way flow of information between these two services. We will conclude with the key quantitative findings of the first multi-site evaluation of IDVAs in the UK, exemplars of an innovative, evidence-based intervention.
Suicide – current maze and future movement
Authors: Vijayakumar L
Published: March 2011

There are a million deaths by suicide every year and by 2020 it is expected to be 1.53 million. The global burden of disease by suicide is also expected to increase from 1.8% to 2.4% signifying that suicide is a major public health problem. Around 60% of suicides occur in Asia. Suicide is a complex human behaviour resulting from a maze of biological, psychological, socio cultural and environmental risk and protective factors that interact intricately. The resulting behaviour varies in patterns and the responses it elicits in different countries and regions. In developed countries, the male to female ratio for suicide is between 2 and 4 to 1. Asian countries, show much lower male to female ratio. Mental disorders occupy a premier position in the matrix of causation of suicide, however in developing countries like China and India, social and environmental factors appear more significant. Exposure to violence and Intimate partner violence is also strongly linked to suicide. Worldwide, suicide by ingestion of pesticides is the commonest method accounting for 30% of suicides. It is more so in rural areas of the developing world. Hence, restriction of access to pesticide through safer individual and community storage and stopping sales of more toxic preparations has the potential to reduce suicide. A 10% reduction in pesticide suicide would result in 30 000 lives saved. Several developed countries have established national suicide prevention programmes, but their effectiveness has not been conclusively proven. The enormity of the problem needs a global movement towards significant reduction of suicides. Suicide prevention should not be viewed as a traditional exercise in health sector but as a social objective.
Preventing morbidity and mortality from injuries to children and adolescents
Authors: Rivara F P
Published: March 2011

Injuries account for nearly 1 million lives lost each year to children under the age of 18 years. In addition to deaths, millions of children each year sustain disability because of injuries. As disability adjusted life years lost from communicable diseases and perinatal causes are reduced, the global burden of injuries will increase. Prevention and control of injuries is an important component of child survival and improving child health globally, although less than 1% of the global health budget is spent on injury control. The armamentarium to address the problem of injuries is large, and solutions to child and adolescent injury control can be achieved though a combination of adaptation of these methods to the local environment and development of new, context specific interventions. The full spectrum of injury control must be employed, encompassing primary prevention, acute care of the injured patient, and rehabilitation to return the injured child as a functioning member of the community. Application of five readily available interventions could decrease child injury deaths by 30% and save 275 000 lives each year. If global child injury death rates in low and middle income countries were the same as in LMIC in South America, 439 000 lives would be saved annually, a decrease from current levels of 46%. Interdisciplinary collaboration within and across countries is critical in accomplishing these goals.
Capacity development for road traffic injuries research in low and middle income countries
Authors:   Road Traffic Injuries Research Network (RTIRN)
Published: March 2011

During the 2010 World Conference on Injury Prevention and Safety Promotion, the Road traffic Injuries Research Network (RTIRN) is organising a parallel session with the objective of presenting multiple strategies for developing capacity for research on Road Traffic Injuries (RTI) in Low and Middle Income Countries (LMIC). Currently the RTIRN is a partnership of 470 individuals and institutions from 60 countries that collaborate to further research on the impact and causes of RTI in LMIC and to identify appropriate interventions to reduce the magnitude of the problem. The experience of one of the nine “Junior researchers” who received funding from RTIRN will be presented in this session. RTIRN has also provided financing for sabbaticals to “Senior researchers”: four researchers from LMIC benefited and one of them will present their experiences in the parallel session. In addition, the final results of lead research project of RTIRN around a Multi-country non-standard helmet use study will be presented for the first time. Collaborating institutions in nine LMIC undertook cross-sectional surveys, markets surveys and reviewed legislation and enforcement practices in order to document the prevalence and factors associated with non-standard helmet use. Findings suggest that wide-spread use of non-standard helmets in LMIC, may limit the potential gains of helmet use programs; and thus parallel legislation and enforcement on non-standard helmets, and strategies aimed at reducing the costs of standard helmets will be required to maximise the effects of existing campaigns. Results from these capacity development projects are of great importance not only to individual scientists but also to the global community of stakeholders interested in RTI prevention.
Making community safety work for Scotland
Authors: Lumsden E
Published: March 2011

In 2007 the new nationalist Scottish Government delivered its first budget and 3-year spending plans and set out the terms of new relationship with local government. This ‘Concordat’ included a move to provide Single Outcome Agreements for each of the 32 local authorities, based on an agreed set of national outcomes. These outcomes include: that we live longer, healthier lives; that we live our lives safe from crime, disorder and danger and; that we have strong, resilient and supportive communities where people take responsibility for their own actions and how they affect others. The Scottish Community Safety Network (SCSN) has been working with its members over the last 3 years to re-align itself with the Concordat to make it a more effective organisation and has expanded its membership to engage more effectively with police forces, fire and rescue services, health organisations and others (such as RoSPA) involved with Community Safety Partnerships. It has also been working to be a more effective “strategic voice” for Community Safety in Scotland with a view to embedding community safety and partnership working to achieve a real change in behaviour and working practices within all community safety organisations. During 2009, the Network incorporated as a company limited by guarantee and was registered with the Office of the Scottish Charities Regulator (OSCR) as a Scottish Charity. The Network is now governed by a Board of Directors (including Elizabeth Lumsden, Community Safety Manager, RoSPA) drawn from across the Community Safety Sector in Scotland. The Network has also been working on, among other things, standardised practice and intervention notes and an improved and recently launched website (www.safercommunitiesscotland.org).
Bringing home safety to the most vulnerable
Authors: Merrill S
Published: March 2011

Safe At Home (National Home Safety Equipment Scheme) is an £14 million initiative to help families keep their children safe and to reduce accident rates in the home. Working with locally based delivery partners the scheme is providing home safety equipment to over 60 000 of the most disadvantaged families in areas with the highest accident rates. The equipment which is provided with a fitting service includes safety gates, fireguards, window restrictors, cupboard locks, corner cushions, cord shorteners and bathmats. The scheme is not just about equipment. Over 2 years it will provide 500 000 families with information and support that will help them to create a safer environment. Safe At Home is also rolling out a comprehensive training programme for delivery partners, with over 3000 training places being offered throughout the scheme. There is a websitehttp://www.safeathome.rospa.com/. Other developments include a DVD with training notes and discussion points which is used as part of a facilitated session. An accompanying height chart, highlighting the key risks and prevention advice left with each family is a practical aid that backs up the information in the DVD. A picture based resource is also available for use in family information sessions.
A framework on generating political priority for global health issues
Authors: Shiffman J
Published: March 2011

Why do some global health issues, such as HIV/AIDS, receive priority from international and national political leaders whereas others also representing high burden – such as pneumonia and injuries – receive little attention? To analyse this question I propose a framework consisting of four categories: the strength of the actors involved in the initiative, the power of the ideas they use to portray the issue, the nature of the political contexts in which they operate, and characteristics of the issue itself. I illustrate this framework by applying it to the case of a global initiative to reduce maternal mortality, launched in 1987. I then draw out implications for the issue of injury prevention. I conclude by suggesting areas for future research on the determinants of political priority for global health issues, a subject that has attracted much speculation but little scholarship.
There are no safe drugs, only safe ways of using them (Voltaire)
Authors: Smith N A
Published: March 2011

All medications can heal or to harm, it is the way they are used that determines patient safety. This paper explores medication-related injury in high risk situations, such as the elderly, children, complex regimes and medications with a low margin of safety. Adverse drug events (ADEs) comprise adverse drug reactions and medication errors, with outcomes that include serious morbidity and even death. Australian findings mirror those of overseas. Up to 30% of hospital admissions and re-admissions for the elderly were associated with ADEs, while up to 3% of attendances at the Emergency Department for children were due to ADEs related to conventional and complementary and alternative medications. The hospital-community interface is high-risk, with 20% of those 65 years and older receiving home care after hospital discharge reporting an ADE. Outside the hospital, in general practice up to 25% of high risk patients reported experiencing an ADE in the previous 3 months. Medication errors include errors made in the prescribing, dispensing, administration, monitoring and documentation, and may not always lead to adverse events. An Australian review of medications prescribed to 1000 high risk general practice patients found 115 errors per 100 patients. Reports of dispensing errors in the community pharmacy were much higher (24%) when “mystery shoppers” were used, compared to voluntary reporting and direct observation (<10%). Errors in medication administration are a particular problem in aged care facilities. The majority of ADEs and medication errors are preventable. Interventions have included medication reviews, patient education and changes to the prescription to patient processes, targeting factors contributing to medication errors such as cognitive, performance, behavioural, communication, work environment and the patient's lifestyle.
National Water Safety Forum – ‘working together for water safety’
Authors: Walker D
Published: March 2011

This presentation considers the challenges and achievements within the UK National Water Safety Forum (NWSF), and in particular through the development of its critical project; the Water Accident Incident Database (WAID). A Government review that considered roles and responsibilities for inland water safety in 2003 offered two key recommendations: (i) That a joined up approach to water safety involving the Government, NGO's, industry and key at risk groups be established, and that (ii) accurate, timely and agreed data pertaining to water incidents be developed. At the time there were a number of challenges to address. These include several committees and databases sometimes offering overlapping and contrary outputs. Competing interests and the natural conflict between those who regulate and create risk are also issues. In some cases decisions regarding appropriate and proportionate response to issues were not always based on good evidence. The establishment of the NWSF is driving an increasingly shared vision for water safety in the UK. This is based upon shared principles and evidence base. There will always be discourse on how we get there; but there is agreement in the community for the continuing need to be ‘working together for water safety’.
Hybridization between the threatened herbBoltonia decurrens(Asteraceae) and its widespread congener,B. asteroides
Authors: DeWoody Jennifer , Nason John D. , Smith Marian
Published: March 2011

Boltonia decurrens (Torr. & A. Gray) A. Wood is a federally threatened herb endemic to the Illinois River floodplain, and currently restricted to fewer than 25 populations. We tested for hybridization between this species and a widespread congener, Boltonia asteroides (L.) L’Hér., at two sites where they are known to occur in sympatry, by comparing morphological and genetic diversity with an allopatric population of each species. Morphological analyses identified significant differentiation between species. Discriminant classification analysis of the morphological data assigned most individuals to one or the other of the two parental species with high probability (>0.95), with only four plants having an intermediate probability of assignment (<0.90) indicative of hybrid origin. Similarly, likelihood-based methods based on genetic marker data (allozymes) failed to detect the presence of F1hybrids in either sympatric population and revealed only low frequencies of F2and backcross progeny. These findings demonstrate that combining morphological and genetic data increases the likelihood of detecting low-scale introgression between closely related species. Even with this combined approach, the low rate of recombination between these species together with their limited sympatry indicate that hybridization does not pose an immediate threat to the genetic integrity of B. decurrens.
Hybridization among foundation tree species influences the structure of associated understory plant communities
Authors: Lamit L. J. , Wojtowicz T. , Kovacs Z. , Wooley S. C. , Zinkgraf M. , Whitham T. G. , Lindroth R. L. , Gehring C. A.
Published: March 2011

Understanding how genetic identity influences community structure is a major focus in evolutionary ecology, yet few studies examine interactions among organisms in the same trophic level within this context. In a common garden containing trees from a hybrid system (Populus fremontii S. Wats. × Populus angustifolia James), we tested the hypothesis that the structure of establishing understory plant communities is influenced by genetic differences among trees and explored foliar condensed tannins (CTs) and photosynthetically active radiation (PAR) as mechanisms. Several findings support our hypothesis: (i) Understory biomass and cover increase along the genetic gradient from P. angustifolia to P. fremontii. (ii) Along the same hybridization gradient, species richness decreases and species composition shifts. (iii) Populus foliar CT concentrations and PAR decrease from P. angustifolia to P. fremontii. (iv) Understory species richness increases with foliar CTs; however, biomass, cover, and composition show no relationship with CTs, and no understory variables correlate with PAR. (v) Structural equation modeling suggests that foliar CTs are a primary mechanism linking overstory tree genetics with understory richness. Using an experimental system dominated by naturally colonizing exotic species, this study demonstrates that a genetic gradient created by tree hybridization can influence understory plants.
Constraints to participation in Canadian forestry advisory committees: a gendered perspective
Authors: Richardson Kristyn , Sinclair A. John , Reed Maureen G. , Parkins John R.
Published: March 2011

Although the public advisory committee has become a very common tool for involving local people in forest management decisions, it does not necessarily broaden the base of public input and may simply replicate the challenges of access, representation, and capacity to participate that are found in wider society. As a category of social exclusion, this study explores why women are significantly underrepresented on forest management advisory committees in Canada and how these committees function as gendered units. Research involved 25 semistructured interviews with members (and former members) of two forest management advisory committees: Tembec in Manitoba and NewPage in Nova Scotia. The strongest evidence in our study suggests that these committees operate within male-dominated institutions and particular masculine norms that are simply taken for granted. Thus, social relations based on gender often go unacknowledged. Findings also showed that the lack of critical mass of women often limited the active participation of the small number of women involved in committee activities. Our empirical observations suggest that unless we attend to gender when involving communities in establishing strategies for forest management, we will reinforce gender disadvantage and exclusion and overrepresent industrial and utilitarian interests of forestry over other community and ecocentric values.
Tree spatial pattern within the forest–tundra ecotone: a comparison of sites across CanadaThis article is a contribution to the series Tree recruitment, growth, and distribution at the circumpolar forest–tundra transition.
Authors: Harper Karen A. , Danby Ryan K. , De Fields Danielle L. , Lewis Keith P. , Trant Andrew J. , Starzomski Brian M. , Savidge Rodney , Hermanutz Luise
Published: March 2011

Although many studies have focused on factors influencing treeline advance with climate change, less consideration has been given to potential changes in tree spatial pattern across the forest–tundra ecotone. We investigated trends in spatial pattern across the forest–tundra ecotone and geographical variation in the Yukon, Manitoba, and Labrador, Canada. Tree cover was measured in contiguous quadrats along transects up to 100 m long located in Forest, Ecotone, and Tundra sections across the forest–tundra transition. Spatial patterns were analyzed using new local variance to estimate patch size and wavelet analysis to determine the scale and amount of aggregation. Compared with the Forest, tree cover in the Ecotone was less aggregated at most sites, with fewer smaller patches of trees. We found evidence that shorter trees may be clumped at some sites, perhaps due to shelter from the wind, and we found little support for regular spacing that would indicate competition. With climate change, trees in the Ecotone will likely become more aggregated as patches enlarge and new patches establish. However, results were site-specific, varying with aspect and the presence of krummholz (stunted trees); therefore, strategies for adaptation of communities to climate change in Canada’s subarctic forest would need to reflect these differences.
Comparing individual tree detection and the area-based statistical approach for the retrieval of forest stand characteristics using airborne laser scanning in Scots pine stands
Authors: Peuhkurinen Jussi , Mehtätalo Lauri , Maltamo Matti
Published: March 2011

Airborne laser scanning based forest inventories employ two major methods: individual tree detection (ITD) and the area-based statistical approach (ABSA). ITD is based on the assumption that trees are of a certain form and can be delineated using airborne laser scanning techniques, whereas ABSA is an empirical method based on the relations between area-level forest attributes and laser echo height distributions. These two methods are compared here within the same test area in terms of their usefulness for estimating mean forest stand characteristics and tree size distributions. All evaluations were performed using leave-one-out cross validation. The average errors in volume and basal area did not differ significantly between the methods. ABSA resulted in overall better accuracies when estimating the diameter and height of the basal area median tree and the number of stems, whereas ITD produced significantly biased estimates for the number of stems and the mean tree size. Tree size distributions were estimated with slightly better accuracy using ABSA. More comprehensive investigations revealed that both methods were not able to estimate forest structure (tree size distribution and spatial distribution of tree locations), which in turn, affected the estimation accuracies.