bluuebunny/crossref_metadata_2025 huggingface dataset:
The epidemiology and clinical features of multiple, non-contiguous spine injuries in children
Authors: Moroz P J , Kingwell S
Published: March 2011

Multiple – non-contiguous spinal injuries (NCSI) are complex injuries frequently missed and with increased potential for adverse outcomes. Adult incidence is reported as 1.6–34%, with greater risk of mortality and fracture instability; the paediatric incidence is unknown. A retrospective review at an academic paediatric trauma centre over a 15 year period identified 25 (11.8%) out of 211 patients with NCSI, with a mean age of 10.7 years. MVC was the primary cause for ages 0–9, while a fall was seen for ages 10–17. The mean number of vertebral levels injured was 3.2. The most common region was the thoracic spine, with a mean of 5.4 (range 1–22) intact vertebral levels between injuries. Twenty-four percent with NCSI had a neurologic deficit versus 9.7% with single level, contiguous injuries (RR 2.48 (1.09, 5.65)). Seven (78%) of nine patients aged 0–9 suffered an associated injury, usually a visceral injury. Mortality was 8.0% in patients with NCSI versus 2.7% in patients with single level or contiguous injury. Children with NCSI have a higher mortality and suffer more serious neurologic injury than with single level injury. Injured spinal segments occur at a greater distance in patients with neurologic injury or death. Younger patients with NCSIs had a high rate of associated injuries. Clinicians must be aware of the incidence of NCSIs in children, as well as their associations.
Strengthening the role of US Public Health Departments in preventing violence: recommendations from an Expert Roundtable Meeting
Authors: Smith P , Scarpetta L , Williams A
Published: March 2011

Despite the growing recognition of violence as a public health issue, public health involvement in violence prevention remains limited. According to the Prevention Institute, there are a number of roles and skills sets that public health can bring to the table in preventing violence, including measuring the problem and progress in addressing it; coordinating the range of needed efforts; and building capacity among multiple players to prevent violence. In addition, public health professionals can develop data-informed strategies and serve as an invaluable advocate for the prevention of violence. During this session, the Safe States Alliance (formerly the State and Territorial Injury Prevention Directors Association) will share recommendations from an expert roundtable meeting held on 13 April 2010 to clarify and prioritise the roles of national, state, and local public health departments in preventing violence.
Child home safety: are we tackling a wicked problem with tame solutions?
Authors: Simpson J , McGee R , Fougere G
Published: March 2011

Unintentional injury to young children often occurs at home. Common causes have been identified and a few interventions proven, but many injuries still occur that appear predictable and preventable. The home is a complex, interactive environment that operates within a dynamic social setting. Child home safety, therefore, could be considered a wicked problem, a concept described in the 1970s by Rittel and Webber. Wicked does not denote an unethical problem, but one that exists in complex ecological systems in which social, cultural, economic and political factors operate concurrently. Solving such problems by using tame solutions that address simple causes and their effects is not effective. The ongoing lack of success in reducing some child home injury at least, suggests that an analysis using a wicked problem approach offers an alternative lens that may help find resolutions. In a qualitative study that explored child home injury, the subject was examined in light of the wicked problem model. Using data obtained from in-depth interviews with health professionals, community family workers and parents of young children, opinions and experiences regarding what influenced keeping children safe were analysed and the wicked problem framework applied. This presentation examines a few of the issues that emerged as being potentially critical to keeping children safe at home, for example, parental fatigue and being time poor. Implications for developing and delivering effective health promotion programmes to reduce child home injury are discussed.
The prevalence and factors contributing to domestic violence among pregnant women attending antenatal clinics in Lusaka urban clinics in Zambia
Authors: Mtonga M D Mwiinga
Published: March 2011

Domestic violence among pregnant women has many faces in Lusaka, Zambia.

Domestic violence among respondents was associated contraction of sexually transmitted infections, loss of pregnancy, bleeding in pregnancy, psychological trauma, divorce and social disharmony.

In this study 385 pregnant women were randomly selected and entered into he study.

Method

A Cross-sectional Descriptive Study of 385 pregnant women attending six randomly selected Antenatal Clinics in Lusaka. A scheduled questionnaire, supplemented with two focus group discussions was used.

Epi Info and Multivariate analysis was done on the data thus sampled.

Results

169 (44%) had a history of domestic violence, 92 (23.9%) had experienced domestic violence in the current pregnancy.

Beatings 116 (68.6%), verbal assault at 55 (32.7), Non-consensual 18 (10.7%) were forms used.

The main perpetrators male intimate partner/husbands.

115 (40.5%) of the victims belonged to Liberal Protestant Christian Denominations, 338 (87.8%) were married and 229 (59.5%) lived in high density areas.

139 (36.4%) believed that a man was justified beating his wife/intimate partner, 101 (26.3%) of the respondents believed that a women was not justified in negotiating sex with her partner.

Women whose husbands abused alcohol were 37 times more likely to beaten than those that did not.

Traditional beliefs made domestic violence acceptable.

Discussions and Conclusions

Domestic Violence among pregnancy women was common and many factors such as age, educational background, traditional beliefs, socio-economical background, church denomination and previous history of domestic violence in their lives.
Is it time to refine the message?: a population based survey of knowledge of first aid for burns and scalds in NSW, Australia
Authors: Harvey L , Barr M , Poulos R , Sherker S , Finch C
Published: March 2011

Appropriate first aid treatment of a burn reduces the severity of injury. Recent research indicates that the optimal time to cool a burn in cold running water is 20 min. However, there are wide variations on the recommended optimal cooling time in the literature available to the public. The aim of this study was to determine current level of knowledge of first aid for a burn of the general population. More than 7000 New South Wales (NSW) residents were asked questions relating to knowledge of first aid for a burn as part of the 2007 NSW Population Health Survey. Logistic regression was used to determine factors associated with a lack of first aid knowledge. Overall, 82% of the population, unprompted, reported that they would cool the burn. Of these, 32.5% reported they would cool the wound for less than 10 min, 42.5% for 10–19 min and 25% for 20–30 min. Speaking a language other than English at home (OR 2.23, 95% CI 1.56 to 3.19), and being over 65 years (OR 1.85; 95% CI 1.45 to 2.29) were associated with a lack of knowledge. The majority of the NSW population know that the application of cold water is appropriate first aid for a burn, however less than a fifth knows to cool the wound for the recommended time. This study demonstrates a gap in public knowledge especially in non-English speakers and those over 65 years and highlights the need for a clear consistent message which identifies the time required to cool the burn wound.
Apply hospital incident command to manage multiple casualties during New Year and Songkran Festival
Authors: Phonburee W , Vivathanasitthipong M , Suwaratchai P , Chamnanphon S
Published: March 2011

Objective

To evaluate the modified Hospital Incident Command System (HICS) used to mange Multiple Casualty during New Year and Songkran Festival.

Background

A New Year and Songkran Festival are the long holidays that encourage many millions of people who travel to/from their hometown. In 2001–2003, there was increase two times patients comparing with an average patients per day. So that Sapprasithiprasong Hospital, apply HICS to prepared and managed Multiple casualty incidents during this periods.

Study design

descriptive study method: data were collected from the injury surveillance. The patients were recruited if they were cared in the hospital during this time (2007–2009). The modified HICS was evaluated by the action plan which make by a subcommittee.

Results

HICS act as the leaders of care management such asPlanningIncreasing healthcare personal and capacity of operations–LogisticsFull range of medical supplies and equipments were stored and easily accessible.

Operations

(1) Management of patient flow and intensive care unit (ICU) beds. The overcrowding effect to patient outcome then the HICS committee limited 35 trauma patients/unit. There were 241–313 trauma patients. Injury organ were head (48.55%–51.03%), extremities (36.33%–41.97%). 8–10%(23–50) of patients were major trauma patients (ISS >15) and admitted at ICU. (2) Operative procedure were performed in 58–63% of trauma patients. Open Reduction and Internal Fixation was the highest procedure. (3) Day by day Conference to collect and manage problem and share data to public sectors.

Conclusion

Implementation of HICS provides command and management of trauma patients during long holidays.
Design of hazardous pharmaceutical waste disposal system
Authors: Prakash E , Babu V
Published: March 2011

The pharmaceutical industries produce various types of life saving drugs which use chemicals of the type of corrosive, toxic, inflammable and hazardous chemicals in the raw stage. In the recent past several industrial disasters have occurred which have taken a heavy toll of human life and property due to the hazardous nature of the chemicals. These incidents have also focused the attention to know and control the various hazards involved during the production of bulk drugs & pharmaceuticals. The hazards in the drugs and pharmaceutical industry may arise due to the hazardous properties of the chemicals such as explosively, inflammability, corrosively, toxicity, chemical degradation and release of free radicals etc. Therefore, it is essential that managers in drug & pharmaceuticals industry must put their best efforts to identify the hazards involved in manufacturing set up of their industrial units and take necessary steps to control them efficiently and to maintain the environment clean. Environmental Protection Act has listed hundreds of chemicals which are hazardous and were discarded which act as the sole active ingredient. These chemicals were classified as the P-list and U-list. Some of these chemical are common pharmaceuticals such as Epinephrine, Warfarin, Nicotine and seven of the chemotherapy drugs. So pharmaceuticals wastes come out during the production are considered as hazardous waste. So these wastes are to be safety handled and disposed. This paper deals with the disposal of the pharmaceutical waste efficiently and eco friendly by designing the proper disposal method such as Secured Land fill and Incineration.
Non fatal Intentional injuries among women and children
Authors: Zaffarullah M W , Karunaratne H M A H
Published: March 2011

We estimated the incidence of intentional injuries occurring between June to November 2009 in the district of Anuradhapura, Sri Lanka having a mid year population of 755 000 which result in 113 persons in sq km. Head and neck injuries have been found to be a main cause for hospital admissions due to assaults. The mean age of the victims was 29.25 years. The commonest area that was assaulted were ears (80.6%). More than 80%of victims were assaulted with hand and 95% of the assailants were known to the victims. The assailant was under the influence of alcohol in more than 78%. Of the victims 22.2%had history of previous assaults. The rate of intentional injury was directly correlated with both the degree of illiteracy and the poverty level of the community of residence. We conclude that intentional injuries are relatively common in this population and that attempts to prevent them must be directed to the women and children who are at greatest risk.
Sport injuries in the European Union
Authors: Kisser R , Bauer R
Published: March 2011

The promotion of physical exercise is an essential strategy of health promotion. However, a sizeable proportion of health gains are lost due to sport injuries. As safety concerns are a factor in the decision to participate in sports, reducing the injury risk is also an essential strategy of public health policies. Prerequisite for targeted programmes is the assessment of injury risks associated with certain activities, facilities, products and services. Usual health statistics (deaths, hospital discharges, medical treatments) do not contain this kind of information. In order to compensate for this shortcoming, 12 EU-countries have implemented a monitoring system with the focus on external circumstances, based on samples of hospitals (A+E departments) – the European Injury Data Base (IDB). It allows for rough but comparable estimates of incidence rates. In the course of an ongoing EU project a survey on sport injuries in the European Union (500 million inhabitants) has been derived, for the first time. According to the IDB definitions of sports, annually about 4.5 million people aged 15 years and older have to be treated in EU hospitals for sport injury. Team ball sports account for 40% of all hospital treated sport injuries, uncontestedly led by football (soccer). Two third of injuries affects men, although with huge differences in the various types of sport. IDB data allow also for more detailed analyses of injury mechanisms. The potential of the IDB system for guiding prevention programmes will also be illustrated in an exemplary way.
Foreign body injuries in the upper-aero-digestive tract in children: the Susy Safe project results
Authors: Gregori D , Foltran F
Published: March 2011

Background

Foreign body injuries in the upper-aero-digestive tract are a common and serious problem among children which is still poorly understood since the difficulty to collect information with a deep level of detail and a wide geographical coverage needed for active surveillance purposes.

Methods

A total of FB 7296 injuries in paediatric patients were gathered by the Susy Safe, EU funded, Web-Registry. The registry involves more than 60 institutions from 24 countries.

Results

About 62% (4047) of children was older than 3 years and the 54% (3700) were males. About 52% of the FBs were inorganics. Among them pearl, ball and marble (14%), toy (5%), coin (4%) were the most recurrent objects. Among organics, fish bones and bones accounted for 21% of cases and nuts for 13%. The shape of the objects was spherical in the 32% of the cases. The volume was estimated and the median value was 37.7 mm3(IR 16.76, 96.74). Complications arose in the 10% of the cases, and hospitalisation was required in the 34% of the injuries with a median length of stay of 1 day. Injuries took place in the absence of adult supervision in the 51% of cases. The 52% of injuries occurred while children were playing and 41% while they were eating.

Conclusion

The Susy Safe Web-Registry is serving as a basis for a knowledge-based consumer protection activity. It distinguishes from other registries for its wide size and by a deep characterisation of objects which caused the injuries.
The incidence of behaviours associated with body checking among young ice hockey players
Authors: Goulet C , Nadeau L , Emery C A , Hamel D , Malenfant S
Published: March 2011

Context

Ice hockey has one of the highest sport participation and injury rates in youth in Canada. Body checking (BC) is the predominant mechanism of injury in leagues where it is permitted.

Objective

To determine if the incidence of physical contacts differs for Pee Wee (PW) players (11–12 years) in leagues where BC is permitted (Alberta) versus players in leagues where BC is not permitted (Quebec).

Design

Cohort study.

Setting

Arenas in Alberta and Quebec, 2007–2008 season.

Participants

PW teams in the top 10% of divisions of play in Quebec (n=10) and Calgary (n=10).

Observation technique

20 games were analysed. Games were video-recorded and analysed by two trained observers.

Main outcome measures

The intensity of the physical contacts was observed with a validated observation system. Five levels of intensity were coded. Level 1 represents the lowest intensity of physical contacts. Rate ratios (RR) adjusted for team clusters based on multivariate Poisson regression was used to compare games played in Calgary and Quebec.

Results

2418 physical contacts were observed. No difference was observed in the rate of physical contacts in games played in both provinces. High intensity physical contacts (levels 4 and 5 combined) were more frequent in Calgary (RR=6.57; 95% IC 3.09 to 13.93).

Conclusions

The results suggest that the greater rate of injury observed in PW leagues where BC is permitted would not be caused by the frequency of the physical contacts but by their intensity.
Prior injury of any intent: a strong determinant of youth suicide unaltered by socioeconomic position
Authors: Zambon F , Laflamme L , Spolaore P , Visentin C , Hasselberg M
Published: March 2011

Objectives

To determine the predicting effect on youth suicide of prior episodes of injuries of various intent (ie, inter-personal and self-directed violence, unintentional and undetermined intent) and the extent to which any association is influenced by family socioeconomic status.

Methods

A nationwide register-based cohort study was conducted covering all Swedish subjects born between January 1977 and December 1991 (N=1 616 342, male/female ratio=105). The cohort subjects were followed up from January 1998 to December 2003, when aged 726 years. Poisson regression and the likelihood ratio test (CI 95%) were used to assess the age-adjusted effect of hospitalisation for injuries of various intents on youth suicide and its effect once adjusted for family sociodemographic and social circumstances.

Results

Each set of exposures independently and significantly predicted suicide mortality. Being hospitalised for self-inflicted injuries or injuries of undetermined intent was associated with a risk of suicide 36–47 times that of subjects never hospitalised in the period under study (95% CI 28.36 to 45.58 and CI 26.67 to 83.87 for self-inflicted injuries and for events of undetermined intent, respectively; overall p<0.01). Similarly, previous events of unintentional injury remarkably increased the risk of suicide (RR 3.08; 95% CI 2.26 to 4.19). These effects were solid and not substantially altered after adjustment for family demographic and socioeconomic circumstances.

Conclusion

Youth suicide is predictable not only by prior suicide attempts but even by prior exposure to injurious assaults and unintentional injuries leading to hospitalisation, regardless of family socioeconomic status.
Safety in sports development of practical guidelines for injury prevention and safety promotion in sports
Authors: Henke T , Luig P , Kisser R , Rogmans W , Kloet S , Schulz D
Published: March 2011

Sport is an important cultural element and one of the most widespread activities. In this context, there is a global consensus that health protection and health promotion are important potentials of sport. It has to be taken into consideration that about 20% of all injuries due to accidents resulting from sporting activities. In particular with regard to popular sports, the benefit for health could be increased by reducing the frequency of sports injuries. Thus, the general aim of the project, which receives funding from the European Commission, is to contribute to the reduction of sports injuries by developing, testing and implementing injury prevention measures and safety promotion strategies for sports with absolute high numbers of participants and injuries.

On the basis of an up-to-date inventory, a consensus on best injury prevention measures and implementation strategies for handball and basketball was built, using a newly developed methodology of a web-based evaluation tool combined with successive expert consultation meetings. Prevention toolkits have been elaborated consisting of media and information to convey preventive contents to stakeholders and target groups in the handball and basketball community. In collaboration with the EHF (European Handball Federation) and the FIBA Europe (Federation Internationale de Basketball) these toolkits will be pilot-tested in two national associations, respectively (Handball: Norway, Czech Republic; Basketball: Sweden, Slovakia) with special focus on acceptance and applicability.

In the light of the test implementation, general guidelines will be elaborated on how to develop, implement and sustain safety management schemes in other sports.
Carefree and injury prone young people: results from Finnish National Victimisation survey 2003–2006
Authors: Haikonen K , Markkula J , Lounamaa A
Published: March 2011

issue

Victimisation surveys are used to compare 15–24-year-olds with 25–64-year-olds in terms of proportion injured and fear of injury.

Methods

National victimisation surveys are interview studies in which a systematic random sample of the Finnish population older than 15 years is interviewed about injuries, violence and crimes. The surveys have been conducted mainly by telephone in 1980, 1988, 1993, 1997, 2003, 2006 and 2009. Data from 2003 to 2006 were merged (n=13553) to obtain high precision to the estimates while still being fairly up-to-date. The proportions of people injured during past year in sports, traffic, home or leisure-time injuries or at least somewhat worried of being injured or violently victimised were estimated in both young (15–24-year-olds, n=2574) and the rest of the working age population (25–64-year-olds, n=10979). Logistic regression models were used to assess the significances of the differences.

Results

Of 15–24-year-olds 13.5% (5.5% of 25–64-year-olds, OR 2.68, p<0.001) sustained at least one sports injury, 3.3% (1.2% of 25–64-year-olds, OR 2.89, p<0.001) sustained injury in traffic accident and 5.6% (5.2% of 25–64-year-olds, OR 1.08, p=0.45) sustained injury in home or leisure-time accident.

Of 15–24-year-olds 45% (59% of 25–64-year-olds, OR 0.56, p<0.001) were worried about getting into a traffic accident, 20% (27% of 25–64-year-olds, OR 0.64, p<0.001) were worried about sustaining home or leisure-time injury and 33% (35% of 25–64-year-olds, OR 0.92, p=0.08) were worried about becoming a victim of violence.

Conclusions

Young people show much greater proneness to accidents but worry less about them. Further research should be targeted accordingly.
Injury prevention in team handball compilation and evaluation of prevention measures in European countries
Authors: Luig P , Henke T
Published: March 2011

Two million EU citizens are active handball players. Thus, handball is one of the most popular and most widespread team sports in Europe. Considering diverging injury definitions the incidence of an injury in handball is around 2/1000 h. In competition the incidence is about 10 times higher than in training, depending on age, gender and performance level. The necessity of effective prevention measures is therefore absolutely perspicuous, but despite this fact experience has shown, that injury prevention is quite an unpopular term.

First, an up-to-date inventory of EU-wide existing prevention measures was accomplished by browsing scientific and non-scientific databases and search engines. Furthermore, accredited handball-experts in the fields of coaching, sports medicine, sports science and injury prevention were asked to review the compiled list in view of completeness. Finally, 75 preventive recommendations, that had been identified, were expert-reviewed again to determine the quality. An online evaluation tool was developed, sampling the experts position towards the presented ideas – not only regarding the pure effectivity of a measure but also the acceptance and the applicability within the handball community.

A subdivision of preventive approaches into (1) training (programmes), (2) technical/political strategies, (3) (protective) equipment/facilities, (4) medical/non-medical support and (5) multi-faceted approaches became obvious. The experts consensus revealed that sustainable prevention can only be attained when the applied measures find favour with active players and coaches. Thus, training programmes with athletic, coordinative and proprioceptive contents, considering the epidemiology and tailored to the demands of handball, may provide the biggest opportunities in reducing injuries.
Systems saving lives: a structured review of trauma systems and their impact on mortality
Authors: Harrington A M , Nathens A B , Yanchar N , Tamim H , Pike I , Macpherson A K
Published: March 2011

Background

For Canadians under the age of 45, injury is the leading cause of death and remains the leading cause of potential years of life lost for those up to the age of 70. Coordination of health services, particularly trauma systems, has the potential to improve treatment and management of the victims. Some research has suggested that trauma systems are associated with a reduction in preventable deaths for injured patients, a reduction in gross mortality, and a reduction in motor vehicle-collision mortality. With the support for the regionalisation of trauma services growing information regarding the effectiveness of trauma systems themselves is key.

Objective

To conduct a systematic review of the effectiveness of trauma systems in reducing mortality.

Methods

We will use the method outlined by the Cochrane Collaboration, and conduct a systematic review of the literature using the following key words: Trauma systems, mortality and injury. To date, 1665 potential articles have been identified including 200 review articles. Articles are currently being screened and will be reviewed when they include relevant evidence regarding traumas systems and mortality for both the adult and paediatric populations.

Relevance

This work will provide information to inform policies related to the development and maintenance of trauma systems.
Piloting a health promotion youth corps
Authors: Green M , Young J , Tobin L
Published: March 2011

For 20 years the Nova Scotia government, through the Department of Environment, has run a successful Youth Conservation Corps that teams up Nova Scotia youth between the ages of 17–24 with community conservation projects. In 2010 the Department of Health Promotion and Protection will create a pilot Health Promotion Youth Corps modelled on the Youth Conservation Corps. The objective is to engage youth in health promotion policy and programming and provide young people with meaningful work experience. In its pilot year the focus will be on injury. The goal is to run and evaluate community-based projects related to road safety, youth violence, sexual assault, sports injury and self-harm. Each year the Youth Conservation Corps hires 50 youth to work on 25 projects across Nova Scotia. During the Health Promotion Youth Corps pilot 10 students will be hired to work on five projects.
Optimising suicide prevention programs and their implementation in Europe (OSPI-Europe) introducing the OSPI model intervention and evaluation methods
Authors: Hegerl U , Schmidt S
Published: March 2011

Suicide is a significant public health issue. The highest rates for completed suicide are found in Europe. In 2005, the European Commission recommended multifaceted and community-based intervention for improving the care of depressed patients and for preventing completed and attempted suicides, and mentioned the European Alliance against Depression (www.EAAD.net, Hegerlet al2004, 2006) as best practice example. Aim of OSPI-Europe with 14 cooperating European partners is to build on the materials, experiences and evidence base provided by EAAD in order to optimise, implement and evaluate a multi-level suicide preventive community intervention program in four European regions in Germany, Portugal, Ireland and Hungary. The intervention comprises education of GPs using training sessions and videos (level 1), public relations activities (level 2), training sessions for multipliers such as priests, social workers, and the media (level 3), offers for high risk groups (persons after suicide attempt) and support of self-help activities (level 4), as well as restriction of lethal means (level 5). The concept, intervention materials, achievements and evaluation activities of OSPI-Europe will be presented. The results will provide EU member states with evidence based concepts and materials for running suicide preventive programmes at regional and national level in Europe.
Suicide contagion in France: an epidemiologic study
Authors: Queinec R , Benjamin C , Beitz C , Lagarde E , Encrenaz G
Published: March 2011

Background

Werther effect is a type of suicide contagion by which the media coverage following the suicide of a famous person entails a significant increase in the number of suicides. Our objective was to determine whether such an effect had been already experienced in France, where the phenomenon has never been documented. Our hypothesis was that there was a significant increase in the national number of suicides following (+1 month) a celebrity suicide.

Methods

We obtained French daily data on suicides from 1979 to 2006 from the CepiDC (INSERM). We selected the six most famous celebrities whose suicide occurred within this period. They were those whose name appeared at least 100 000 times in a popular web search engine. Data were analysed using the Seasonal ARIMA model.

Results

Pierre Beregovoy (politician) and Kurt Cobain (musician) suicides were followed by a significant increase in the number of suicides in the French general population (+17.7% and +9.2% respectively). Dalida (singer) suicide had a significant effect among people aged from 45 to 59 only and Soeur Sourire (singer) suicide among women only. No effect was found after Nino Ferrer (singer) and Gilles Deleuze (philosopher) suicides. Some of these suicides were strongly covered by the media; a qualitative analysis showed that, in most of cases, media did not follow the existing guidelines about suicide report.

Discussion

Suicide contagion description and comprehension can help us to lead preventive actions, and to raise medias awareness of the existing guidelines.
New death notification form and training in the United Arab Emirates as improved sources of data on injury and other main causes
Authors: Barss P , Grivna M , Al-Dhaheri A , Harrison O
Published: March 2011

Introduction

Insufficient clarity in death notification forms, together with insufficient training, contributed to invalid reporting and ranking of underlying causes in the United Arab Emirates (UAE). A 2006 regional study found 10% of deaths incorrectly described by physicians with underlying cause as cardiac arrest, resulting in misclassification. Chart review increased injury, cancer and diabetes mortality, while cardiovascular dropped from first to third. Hence it was clear reporting could be improved.

Methods

University and government professionals in the large Abu Dhabi emirate collaborated in early 2007 to develop a research-based death notification form and provide reporting workshops for hospital physicians and public health professionals. Check-box data fields were pre-coded with ICD-10-WHO codes. For injury, supplementary information included intent, external cause and location, and if traffic-related, road user type and safety devices such as restraints or helmets. Product or chemical-related deaths were documented. A pilot in the region of the original study led to emirate-wide revisions. Proportional mortality was later reassessed.

Results

The pilot found significant improvement in reporting by physicians and public health professionals. Throughout the Emirate, health priorities were reordered with injury accounting for 23% of deaths and the leading cause in 2007. However, during 2008 there was significant resurgence in reported cardiovascular deaths.

Conclusion

Improved death reporting forms and training were associated with improved reporting of main causes including injury and reduced use of inappropriate underlying causes. Nonetheless, skilled monitoring is needed to sustain improvements in rapidly developing countries with high turnover of clinical and public health staff.
Addressing the inadequacies of Nigeria's national vehicle visibility scheme for enhanced safety
Authors: David O , Ojugbana C C , Obinna K , Ifeanyi A
Published: March 2011

Statement of Purpose

Due to increasing road crashes at nights, the Nigerian road safety regulating agency, implemented a scheme that requires all vehicles to carry retro reflective stickers at their back bumper. The scheme in its 6-month period of implementation has been greeted with skepticisms.

Objective

This research seeks to investigate the Nigerian national vehicle visibility scheme, examine the threats and make recommendations.

Method

A 2-week study was carried out on three major highways; a total stretch of 282 km. Scheme compliance was recorded and visibility of the retro reflective stickers was monitored at nights. Interviews were conducted in 20 commercial motor parks. 300 questionnaires were randomly distributed.

Summary of Results

Data obtained were analysed statistically. It showed scheme compliance of 58–80%. 36% of respondents agreed that theft of stickers was a major threat. 35% of respondents stated that the quality of the stickers depreciated. 86% agreed that the stickers were very useful at nights but 67% agreed that the stickers were of no value to them during daytime. 58% of the vehicles examined had stickers with very poor reflective features.

Conclusion

The scheme makes huge contribution towards reducing road casualties. To minimise theft and enhance usefulness of stickers at daytime, registration numbers of vehicles and relevant road safety messages should be embossed on stickers. For quality control, all materials used should meet specific type certification. Scheme when reviewed can be replicated in other developing countries with night visibility problems on the roads.
Risk factors and possible interventions for injury severity of five types of rural road crashes
Authors: Ewert U , Eberling P
Published: March 2011

In Switzerland more than 50% of all road fatalities occur on rural roads. Five different types of crashes (head-on collisions, collisions with roadside obstacles, collisions at intersections, crashes without collisions, collisions with pedestrians) are analysed with regard to the risk factors for being fatally or severely injured versus being slightly or not injured.

Five logistic regressions of the police accident statistics lead to 21 risk factors, among them type of vehicle, use of seat belt or helmet, alcohol use, type of roadside obstacles, type of road, age and gender, etc.

About 25–40% of the variance could be explained, depending on the type of crash.

Several recommendations for the reduction of the risk factors were derived and will be presented. They relate to road construction, behaviour change and police enforcement.
Prevalence and determinants of violence against emergency medical care providers in Karachi, Pakistan
Authors: Siddiqui E U , Ejaz K , Razzak J A , Shehzad M U , Jamali S
Published: March 2011

Background

Violence against healthcare workers is a growing problem. About 9% to 49.5% violence has been reported from different parts of the world. Healthcare providers in emergency departments throughout the world are exposed to workplace violence.

Objective

To determine the prevalence and determinants of workplace violence against emergency care providers in tertiary care hospitals of Karachi, Pakistan.

Methods

The study was conducted in emergency departments of four tertiary care hospitals of Karachi. Interviews after written consent were conducted with physicians, registered nurses, nursing aids, porters, guards, unit receptionists and housekeepers. Stratified cluster sampling was adapted.

Results

Of 384 respondents, 250 (65%) were males. Of all, 274(71%) reported verbal abuse, 72(20%) reported physical abuse within last 1 year. Physical abuse was equally faced in both private and public hospitals. Weapons were involved in 31(41%) cases of physical attack. Of all respondents, 96(35%) females suffered verbal abuse compared with 23(30%) who faced physical violence. Of 76 respondents, 24 (32%) felt useless to report the incident to the authorities. Working as a physician (OR 2.06; 95% CI 1.06 to 4.02), having working experience of less than 5 years (OR 2.41; 95% CI 1.05 to 5.57) and having 11 to 15 coworkers on call (OR 3.52; 95% CI 1.34 to 9.23) were identified as determinants of violence.

Conclusion

Physical violence with weapon was noted in our set up, along with verbal violence. Physicians with work experience of less than 5 years are more prone to face such incidences.
Quality indicators for trauma registries – towards agreement on a world wide standard?
Authors: Lauritsen J M , Ringdal K G
Published: March 2011

Worldwide, approximately 5 million persons died as a result of an injury in 2000 worlds burden of disease. Almost 50% of the worlds injury-related mortality occurs in young people aged between 15 and 44 years, the most economically productive members of the global population. Trauma registries constitute a major source for research on injury prevention (primary prevention), and enables comparative analyses of trauma care and outcome to provide quality improvements in trauma care (secondary prevention). However no agreed common set of defined quality indicators have been published for general use across continents. In 2007, an expert panel consisting of representatives from major trauma organisations in Europe created the Utstein Trauma Template, a European minimum core dataset and definitions for documenting and reporting data on severely injured patients, containing patient factors, operational factors and system factors. Trauma registries across Europe have agreed to implement this dataset. To make proper evaluations of trauma care an agreed set of quality indicators must be created. It is the purpose of this workshop to start an open process of defining a minimal set of quality indicators for evaluation of trauma care. Trauma registries, trauma organisations as well as trauma interested clinicians and researchers are suggested to take part in an open discussion. In extension of the workshop a postconference process leading to publication of a suggested set of quality indicators is envisioned.
The business case for interventions to prevent fall injuries in older adults
Authors: Carande-Kulis V G , Stevens J , Beattie B L , Arias I
Published: March 2011

A business case for programs to prevent falls in older adults was conducted by the U.S. CDC National Centers for Injury Prevention and Control (NCIPC) and the National Council on Aging (NCOA). Interventions studied were as follows: the Otago Exercise Program delivered to (a) persons aged 65 and older and (b) persons aged 80 and older, the Tai Chi: Moving for Better Balance program, and the Stepping On program. The average intervention costs were $415 for both age-groups of the Otago Exercise Program, $216 for Tai Chi and $155 for Stepping On. Benefits in averted direct medical costs were $363 for the Otago Exercise Program for 65 and older, $691 for the Otago Exercise Program for 80 and older, $570 for Tai Chi and $311 for Stepping On. The net present values (NPVs) were $354 for Tai Chi, $276 for the Otago Exercise Program for 80 years and older and $156 for Stepping On. The Otago Exercise Program for 65 and older showed a negative NPV. The Tai Chi program at $1.6 per dollar invested (160% return) had the higher ROI followed by Stepping On at $1 per dollar invested (100% return) and the Otago Exercise Program for persons 80 and older at $0.7 per dollar invested (70% return). The magnitudes of the ROIs for the above interventions indicate excellent financial performances when compared to the 12% historical return of the U.S. Standard and Poors 500 index.
School-based program for injury prevention and safety promotion in Ismailia city, Egypt
Authors: El-Sayed H , Gad S , Saied H , Gamal D
Published: March 2011

Objectives

To determine the pattern, risk factors and consequences of injuries among school children, and to implement an injury control program in preparatory school in Ismailia city and to evaluate its impact on the knowledge and behaviour of the students.

Design cross-sectional school-based study of selected preparatory school in Ismailia city, followed by a cohort prospective school-based study to implement injury control program and to evaluate its impact.

Methodology

Personal and demographic characteristics of the recruited students and data on injuries that needed medical care or caused activity restriction during the last year were collected. Educational and training program targeting school children was developed and implemented in the chosen school, aiming at improving students' knowledge about injury prevention and first aid for injuries. The program included series of lectures, posters, video-presentations and practical injury first aid training program.

Results

The study included 197 pupils with a mean age of 13.16+1.61 years. Incidence of injuries among school children was 35.5%. The most common external causes of injuries sustained by the children were falls (44%) and near drowning (16%). The study revealed significant lack of knowledge concerning causes, risk factors, prevention and first aid for injuries among the studies pupils. Children knowledge about these parameters improved significantly after the health promotion and training program implementation.

Conclusions

There is great need for safety promotion program for injury prevention and for injury first aid training for school children. This program should also include improvement of safety measures at schools, streets and at home.
Making the case for investing in suicide prevention interventions: estimating the economic impact of suicide and non-fatal self harm events
Authors: McDaid D , Bonin E , Park A , Hegerl U , Arensman E , Kopp M , Gusmao R
Published: March 2011

Background

Reducing the rate of suicide remains a key public health goal. This paper estimates the lifetime costs of suicide and non-fatal self harm events in four European countries (Germany, Hungary, Ireland and Portugal) participating in the Optimising Suicide Prevention in Europe (OSPI) project. It then looks at what level of suicide reduction would need to be achieved for an area based suicide prevention intervention to be considered cost-effective.

Methods

Different elements of cost: direct costs (eg, police, funeral services, healthcare use), lost productivity and intangible costs of pain, grief and premature loss of life are described. Data on suicide rates and non-fatal suicide attempts, life expectancy and economic activity in Germany, Hungary, Ireland and Portugal are then used to model the lifetime costs. Decision modelling techniques are used to determine the effectiveness threshold required for a multi-level community based prevention intervention, such as that used in the OSPI project, to be considered cost-effective.

Results

The costs of suicide are substantial and impact across sectors. The average lifetime costs of each completed suicide are around 2 million in EU countries. Increasingly policy makers want to know not only about effectiveness but also the cost effectiveness of interventions when determining how best to make use of budgets. Our analysis suggests that if an area-wide suicide prevention intervention were to achieve only a modest 1% reduction rate in the number of suicides, in most scenarios this remains highly cost-effective.
Geospatial mapping of suicide clusters in Cantebury New Zealand
Authors: Larkin G L , Beautrais A L , Xu H
Published: March 2011

Background

Despite strong public and professional interest in suicide clusters, the scientific literature on this subject has been dominated by anecdotal reports. Precise definitions of suicide clusters are lacking.

Aim

To apply geospatial mapping methods to the problem of identifying suicide clusters.

Methods

All suicide decedents (N=918; 76% male; age range 12–100 years) that occurred in one region, Canterbury (population, 450 000) of New Zealand from 1991 to 2008, using official New Zealand Ministry of Health data. Suicides were defined by coronial verdict. Latitude and longitude coordinates for the residential street address for each decedent were geocoded using Google maps. Suicide cluster candidates were identified by SaTScan 8.0 using Kuldorffs space-time permutation model.

Results

Geospatial mapping identified nine suicide clusters involving a total of 43 decedents (4.7% of all suicides). The median age of cluster decedents was 29 years (range 15–84 years); 37.2% of cluster decedents were aged <25 years. The median number of suicides per cluster was 4 (range 3–8); the median timeframe (from index to final case) of a cluster was 83 days [range 25 days (3 suicides) to 445 days (8 suicides)]. All members within each suicide cluster were located within circles of radii<1.6 km. The minimum radius of a cluster was 97 m (4 suicides who died within 114 days); the minimum time for a cluster was 26 days (3 suicides, circle radius 261 meters).

Conclusions

Geospatial mapping is a useful new approach to identify suicide clusters and develop empirically based definitions of suicide clusters.
Brain and spinal cord injury in Australia – economic cost and burden of disease
Authors: Collie A , Keating C , Pezzullo L , Gabbe B , Cooper J , Brown D , Olver J , McCartin F , Trethewey P
Published: March 2011

Background

Despite rapidly increasing knowledge of the biological, physical, emotional and social impact of traumatic brain injury (TBI) and spinal cord injury (SCI), understanding of the economic impact of these injuries is limited.

Aims

Determine the economic impact and burden of disease (BoD) of TBI and SCI in Australia. Compare the economic impact and BoD of TBI and SCI with other conditions. Model the potential impact of TBI and SCI clinical and rehabilitation strategies on the economic cost and BoD.

Methods

An incidence-based costing approach was employed, measuring the number of new cases of TBI and SCI in the base period (calendar year 2008) and the costs associated with treatment, other financial and non-financial costs over the person's lifetime.

Results

Total costs of TBI and SCI were estimated to be $8.6 billion and $2.0 billion, respectively, and accounted for 30 458 and 5090 disability-adjusted life years (DALYs) respectively. The financial cost per case per year of severe TBI was higher than all comparator conditions except muscular dystrophy. Costs for quadriplegia were higher than all comparator conditions.

The first CEA demonstrated that use of saline fluid resuscitation in TBI was less costly and avoided more DALYs than albumin. The second CEA demonstrated that continuous positive airway pressure for sleep disorders in quadriplegia was cost effective according to WHO criterion.

Conclusions

The financial costs and BoD associated with neurotrauma are substantial. Two clinical interventions developed in Australia with demonstrable health benefits are also cost-effective.