bluuebunny/crossref_metadata_2025 huggingface dataset:
HELMET USE IN BIXI CYCLISTS IN TORONTO, CANADA: AN OBSERVATIONAL STUDY
Authors: Bonyun M , Camden A , Macarthur C , Howard A
Published: October 2012

Background

In May 2011, the BIXI bikesharing programme was launched in the downtown core of the City of Toronto, Canada, providing public access to bicycle rentals for short-commutes within the city.

Objective

To investigate the use of helmets for cyclists choosing to use BIXI bikes in comparison to personal bike riders in the City of Toronto.

Methods

A prospective cohort study design was used to compare the prevalence of helmet use for male and female cyclists on personal bikes in comparison to those on BIXI bikes during the weekday morning and evening commutes over the summer, 2011.

Results

Of the 6732 sample size, 306 cyclists on BIXI bikes and 6426 personal bike riders were observed. Overall, 50.3% of cyclists wore helmets. The proportion of BIXI bike riders using helmets was significantly lower than the proportion of helmet users on personal bikes (20.9% vs 51.7%, respectively, p<0.0001).

Significance/Contribution to the Field

Although the BIXI bike programme has provided an alternate means for Torontonians to use a bicycle, cyclists using BIXI bikes are much less likely to wear a helmet. Since the prevalence of helmet use in cyclists in general is already low, helmet use should be especially promoted in BIXI bike riders in order to promote a safe and healthy environment for cyclists.
DO VISIBILITY AIDS REDUCE THE RISK OF MOTOR-VEHICLE INJURY IN BICYCLISTS?
Authors: Hagel BE , Ruest N , Morgunov N , Embree T , Couperthwaite AB , Voaklander D , Rowe BH
Published: October 2012

Background

There is limited literature regarding the effectiveness of visibility aids (eg, reflectors, lights, fluorescent clothing) in reducing the risk of a bicyclist- motor-vehicle (MV) collision.

Objectives

To determine if visibility aids reduce the risk of a bicyclist-MV collision.

Methods

Cases were bicyclists who were struck by a MV and assessed at emergency departments (EDs) from May 2008-October 2010 in Calgary and Edmonton, Alberta, Canada. Controls were bicyclists with non-MV injuries from the same EDs over the same time period. Participants were interviewed about their personal and injury characteristics, including use of visibility aids (clothing colour or reflective clothing, bike reflectors, etc). Injury information was collected from charts. ORs and 95% CIs were estimated for visibility aids after adjustment for confounders using logistic regression.

Results

There were 2403 injured bicyclists with 278 MV cases. The risk of a bicyclist-MV collision increased with age. Commuting also increased the odds of MV collision (OR 5.8; 95% CI 4.5 to 7.5). After accounting for location speed limit, bicyclist speed, and previous injury, white (OR 0.25; 95% CI 0.07 to 0.9) or other coloured (OR 0.45; 95% CI 0.2 to 0.9) compared with black clothing on the upper body reduced the odds of collision. Fluorescent clothing was associated with MV collisions (OR 1.7; 95% CI 1.0 to 2.8), even after adjusting for commuting and bicycling location.

Significance

Clothing choice may be important in reducing the risk of MV collision; however, factors beyond the individual also need to be examined.
SAFETY IN SCHOOL SPORTS (TEKO)
Authors: Jussila AM , Oksanen R , Ojala A , Parkkari J
Published: October 2012

Background

In Finnish elementary schools injuries happen mostly in physical education (PE) classes, recesses and on the way to school. Most injuries are mild, but treatment can be time consuming and expensive. Especially knee, low back and head injuries may cause long-term pain and disabilities.

A remarkable part of these injuries can be prevented by enhancing pupils' motor skills and awareness of injury risks by improving quality and contents of PE and health education classes, and taking care of safety equipment and environment.

Methods

The Sports and Exercise Safety in Finland programme (LiVE) and its second nationwide implementation project TEKO (2010−), is delivering research findings and producing educational material to the internet to promote physical activity and safety of sports and leisure time (http://www.tervekoululainen.fi). The main target group for TEKO is secondary school teachers and pupils.

Results

In TEKO project the safety promotion is focused on 10 segments; physical activity, sports skills, maturation, nutrition, rest and sleep, environment and equipment, health care, atmosphere and rules, injuries and support network. Teachers can use free of charge information packages and practical toolkits per segment to enhance the sports and leisure time safety.

Contribution to the Field

The implementation set up developed in TEKO project has received a positive feedback. Experiences indicate that this kind of set up might be a spreadable and affordable way to do safety promotion in schools.
DOES BODY CHECKING POLICY TO DISALLOW BODY CHECKING REDUCE THE RISK OF INJURY AND CONCUSSION IN 11 AND 12-YEAR-OLD NON-ELITE ICE HOCKEY PLAYERS IN CANADA?
Authors: Emery CA , Macpherson A , Kang J , Hagel B , Black A , Romiti M , Meeuwisse WH
Published: October 2012

Background

Ice hockey has high participation and injury rates in youth in Canada. Body checking (BC) is the predominant mechanism of injury. Research has informed policy change disallowing BC in non-elite Pee Wee leagues (ages 11–12) in some provinces.

Objective

The objective of this study was to determine if the risk of injury and concussion differ for non-elite Pee Wee ice hockey players in leagues where BC is permitted (Alberta) versus leagues where policy no longer permits BC (Ontario).

Methods

This is a cohort study completed in Alberta and Ontario during the 2011/2012 season. Players were from Pee Wee teams in the lower 70% of divisions of play. A previously validated injury surveillance system was used to collect preseason, exposure and injury data.

Results

Forty-four teams from Alberta (n=658) and 32 from Ontario (n=258) participated. There were 144 injuries (Incidence Proportion (IP)=21.88 (95% CI 18.78 to 25.24)) and 83 concussions (IP)=12.61 (95% CI 10.17 to 15.4)) in Alberta and 17 injuries (IP=6.59 (95% CI 3.88 to 10.34)) and 11 concussions (IP=4.26 (95% CI 2.15 to 7.5)) in Ontario. The Alberta versus Ontario Risk Ratio was 3.34 (95% CI 2.06 to 5.41) for all injury and 2.96 (95% CI 1.6 to 5.46). for concussion.

Significance

There was a 3-fold increased risk of injury and concussion in non-elite Pee Wee ice hockey players in leagues where BC is permitted compared to a cohort where BC is no longer permitted. These findings have important implications for further BC policy change to reduce the public health burden of injury and concussion in youth ice hockey.
LEGAL RISK MANAGEMENT IN THE AUSTRALIAN FITNESS INDUSTRY: IDENTIFYING THE PUBLIC LAW RISKS
Authors: Keyzer P
Published: October 2012

Background

The fitness industry has a critical role to play in supporting healthy lifestyles. However exposure to legal liability risks represents a potentially significant cost to many service providers that may impact on business, and therefore service availability.

Aims

There is a growing literature examining legal liability exposure in private law areas, such as personal injury, contracts and consumer law. However customers and employees of fitness services may also be subject to other psychosocial hazards such as sexual harassment, bullying, disability discrimination and discrimination on the ground of sexuality. Human rights law also creates important obligations to take into account.

Methods

This paper reviews the literature on what are broadly termed ‘pubic law’ risks in the fitness industry.

Outcomes

The paper identifies a number of research questions arising from this review for further research.

Significance

This paper will help identify what sustainable changes could be made to Australian regulation for more effective risk management in the health and fitness industry in order to prevent the legal liability associated with the risk of adverse psycho-social health outcomes.
EXPERIENCE FROM COMMUNITY BASED CHILDHOOD BURN PREVENTION PROGRAMME IN BANGLADESH: IMPLICATION FOR LOW RESOURCE SETTING
Authors: Mashreky SR , Rahman A , SvanstrÖm L , Linnan MJ , Shafinaz S , Rahman F
Published: October 2012

A comprehensive community-based burn prevention framework was developed for rural Bangladesh taking into consideration the magnitude, consequences of burns, risk factors of childhood burn, health seeking behaviour of parents after a burn injury of a child and the perception of community people. This paper explains the comprehensive framework of the childhood burn prevention programme and describes its acceptability, feasibility and sustainability.

A number of methodologies were adopted in developing the framework, such as, (i) building up relevant information on childhood burn and prevention methods, (ii) arranging workshops and consultation meetings with experts and related stakeholders and (iii) piloting components of the framework on a small scale.

Lack of supervision of the children, hazardous environment at home and the low level awareness about childhood burn and other injuries were identified as the major attributes of childhood burn in Bangladesh. To address these factors ‘Triple S’ strategies were identified for the prevention framework.

These strategies are:

• Safe environment.

• Supervision.

• Skill development.

According to these strategies, home safety, community crèche, school safety, formation of community groups and general awareness activities were identified as the different components of the childhood burn prevention framework in rural Bangladesh. The framework was piloted in a small scale to explore its feasibility acceptability and sustainability.

It was found to be acceptable by the community. It is also expected to be feasible and sustainable as very low cost and locally available technology and resources were utilised. Large scale piloting is necessary to explore its effectiveness and ability to scale up all over the country.
PREVENTING RISKY DRIVING AND ALCOHOL MISUSE AMONG YOUNG ADULTS: A RANDOMISED CONTROLLED TRIAL IN THE EMERGENCY DEPARTMENT
Authors: Sommers M , Lyons M , Shope J , Sommers B , McDonald K , Fargo J
Published: October 2012

Background

Emergency department (ED) visits provide an opportunity to reduce risky driving and alcohol misuse, thereby reducing the risk for future injury.

Aims/Objectives/Purpose

To determine the efficacy of Screening, Brief Intervention, and Referral to Treatment (SBIRT) addressing risky driving and alcohol misuse.

Methods

We implemented a randomised controlled trial of SBIRT with follow-up through 12 months. ED patients (N=20 027) ages 18–44 were screened for risky driving and alcohol misuse. Participants who screened positive for both behaviours (n=476) were randomised to brief intervention (BIG), contact-control (CCG), or no-contact-control (NCG) groups. BIG (n=150) received screening, a 20-min assessment, and two, 20-min interventions. CCG (n=162) received screening and a 20-min assessment and NCG (n=164) received screening and were interviewed at 12 months. Outcome measures included self-reported driving behaviours (safety belt use, speeding >20 mph above speed limit) and alcohol consumption (≥5 standard drinks/day, maximum drinks/6-h period).

Results/Outcomes

Three primary outcomes were significantly lower (p<0.05) in BIG compared to CCG through 6 or 9 months, but not at 12 months: Safety belt use at 3, 6, and 9 months (6% increase for BIG, but a 11% decrease for CCG); maximum number of drinks in a 6-h period at 3 and 6 months (20% decrease for BIG, but only 11% for CCG); and ≥5 standard drinks/day at 3 and 6 months (18% decrease for BIG, but only 10% for CCG).

Significance/Contribution to the Field

SBIRT can reduce risky driving and alcohol misuse, but its effects did not persist after 9 months.
PILOT TESTING OF TRAUMA REGISTRY IN A SINGLE TERTIARY CARE HOSPITAL OF PAKISTAN: RESULTS FROM INITIAL DATA ANALYSIS
Authors: Mehmood A , Razzak JA , Kabir S , Mackenzie EJ , Hyder AA
Published: October 2012

Background

Trauma registries play an integral role in the assessment of quality of trauma care and hospital based injury surveillance. We present the results of pilot study of a locally developed electronic “Karachi Trauma Registry”(KITR) conducted in an urban tertiary care hospital of Karachi, Pakistan.

Methods

Data for KITR was collected over a three months period from November 2010 to January 2011. All patients who presented through the Emergency Department (ED), Aga Khan University, Karachi Pakistan with a diagnosis of injury as defined in ICD-9. Basic demographics, injury details, hospital course and outcome were recorded. The registry based analysis was done to determine the patient characteristics injury severity, probability of survival and outcome.

Results

Data of 542 patients was entered and analyzed. Their mean age was 27 years and 72.5 % were males. About 87% had blunt injury while 13% had penetrating injuries. Fall followed by motor vehicle crashes were the most common mechanisms of injury. Head and face were the most frequently injured anatomical regions. The mean Injury Severity Score was 4.99 and 97% had TRISS of >50%. 287 (53%) patients had no disability, 245 (45.2%) had temporary handicap and 10 (1.84%) had permanent handicap at the time of discharge. Pre-hospital time in 81% of cases was < 4 hours and mean ED length of stay was 31 hours.

Significance

The registry shows that most patients had minor injuries with high probability of survival; however delays in presentation and disposition can affect the outcome.
HAZARD REGRESSION MODELS OF EARLY MORTALITY IN TRAUMA CENTRES
Authors: Clark D
Published: October 2012

Background

Factors affecting early hospital deaths after trauma may be different from factors affecting later hospital deaths, and the distribution of short and long prehospital times may vary among hospitals.

Objective

We wished to explore whether hazard regression (HR) models might be more useful than logistic regression (LR) models for analysis of trauma mortality, especially when hospital effects at different time points are of interest.

Methods

We obtained data for trauma centre patients in the 2008–2009 US National Trauma Data Bank (NTDB). Cases were included if they had complete data for prehospital times, hospital times, survival outcome, age, vital signs, and severity scores. Subjects were excluded if pulseless on admission, transferred in or out of hospital, or Injury Severity Score<9. We compared LR models predicting 8-h survival to HR models with survival censored at 8 h, using the same covariates and including an indicator for each hospital. HR models were then modified to allow time-varying hospital effects.

Results

85 327 patients in 161 hospitals met inclusion criteria. Crude hazards peaked initially, then steadily declined. LR and HR models estimated similar hospital effects when HRs were assumed constant. However, time-varying HRs revealed major fluctuations in hospital-specific effects at different times after injury.

Significance

HR models with time-varying HRs reveal inconsistencies in hospital effects, data quality, and/or timing of early death among trauma centres. HR models could also be adapted for censored data such as might result from interhospital transfers or delayed declarations of death.
HOW YOUTH DEVELOPMENT AND COMMUNITY COLLABORATION CONTRIBUTE TO SAFE COMMUNITIES
Authors: Davis R
Published: October 2012

Background

The Wellington Boys' and Girls' Institute (BGI) is a youth development organisation that works in partnership with the Wellington City Council (WCC) to make Wellington a safer community for all its residents, particularly young people. Collaboration between BGI, the WCC and other community groups has had a range of positive outcomes that contribute to city safety.

Objective

To explore the value of collaboration between youth development organisations, city authorities and other community groups in improving city safety.

Outcomes

BGI and the WCC work closely together to develop responses to issues affecting young people and families in Wellington City, along with other partners including government agencies, churches, community groups, private businesses and the Police. This collaborative approach has led to the initiation of multiple innovative projects (such as mentoring, adventure therapy and graffiti vandalism prevention programmes) that have had a positive effect on city safety including reduction of crime, improved mental health and increased youth, family and community resilience. One of the key learning outcomes from this case study has been that collaboration between multiple partners and the synergy that is created through working together leads to increased opportunities and greater innovation in addressing issues of community safety.

Significance

Government agencies and city authorities would benefit from working together with local community groups when seeking to address issues of community safety.
PROMOTING SAFETY AT WORK IN COOPERATION WITH THE LOCAL COMMUNITY
Authors: Bodankin R , Weisberg E , Zimer A
Published: October 2012

Background

The project is a pilot study of promoting safety at work in cooperation with the local community. Similar models called ‘A Safety Community’ already operate around the world in different environments. In this project we achieved the commitment of the municipalities to promote safety in local businesses.

Purpose

Prevention of accidents at work by creating a net of local partnerships within the communities aiming to promote appropriate initiatives.

Methods

Two cities have been chosen for this pilot—Ràanana, a Jewish city, and Um El Phahem, an Arab city—and both have a large number of small businesses (up to 25 employees), lacked any safety guidance. An intervention programme included a risk survey, a follow up of the recommendations, guidance for workers and hearing tests. The municipalities were responsible for recruiting the firms and granting excellence certificates to safe businesses.

Results

In both cities about 70% of the businesses responded positively to participation in this pilot. About 50% of the hazards found in the risk survey were eliminated by businesses owners. Direct contact has been established between the workplaces, the municipalities and the local occupational clinics.

Significance

This project is innovative in Israel. There is no other project in which the municipalities are involved in the improvement of safety in the workplaces.
GUADALAJARA, MEXICO: DRINKING AND DRIVING STRATEGY
Authors: Rojas R , De Leon Ponce M
Published: October 2012

Background

Mexico occupies the 7th place worldwide and the 2nd in Latin America on deaths for road traffic accidents. Among the population aged 15–29, traffic accidents represent the first cause of death. Guadalajara, Jalisco is on the first 10 municipalities on deaths for traffic accidents, and it is estimated that 30% of these deaths are related to drinking and driving. This scenario sets up a severe and complex public health problem.

Objective

To reduce injuries and fatalities from road traffic accidents in Guadalajara's population aged 15–29.

Methods

A drinking and driving prevention strategy has been implemented in Guadalajara's metropolitan area since 2008. The strategy consisted of the following activities: Conduct a baseline survey; involvement of the civil society and NGOs; amending the law; strengthening the enforcement capacity; implementing a social marketing campaign; Conducting BAC testing.

Results

Before August 6th, 2010 the minimum legal BAC limit was 1.5 grams of alcohol per litre of blood, with the new law, known was ‘Lifeguard Law’, the minimum legal BAC limit was reduce to 0.5 g/l. Before this law amendment the penalty for driving above the legal limit was 30 days of minimum wage, and now it is from 150 to 200 days of minimum wage ($7000–$9000 MXN). Other outcomes of the drinking and driving strategy were the following: the creation of a road traffic victims NGO,VIVIAC, a youth NGO,Salvaguarda, and a citizen observatory; a technical expert alcoholometry certification programme; National manual for the alcoholometry programme. These resulted in a decrement in mortality with alcohol involved in population aged 15–29 of 21.6% (from 74 in September 2009–August 2010 to 58 in September 2010–August 2011).

Conclusions

This shows that the enforcement of interventions through an integral and multisectoral model, based on scientific-evidence, results in the reduction of deaths on the roads
THE IMPACT OF THE U-VISA ON STOPPING VIOLENCE AGAINST IMMIGRANT WOMEN IN THE USA
Authors: Olson L , Kamimura A , Gonzalez M
Published: October 2012

Background

The Violence Against Women Act created the U-visa to strengthen the ability of law enforcement to prosecute cases of domestic violence and other violent crimes committed against immigrants who are abused by a boyfriend or person who is not a spouse or who is not a US citizens or permanent resident.

Objective

Understand the development of the relationship and the history and patterns of abuse.

Methods

Qualitative analysis of 48 U-Visa affidavits. The affidavit, one element of the evidence for U-Visa applications is the chronological story told in the immigrants' own words of her relationship with the perpetrator and the abuse.

Results

Most applicants met and partnered with perpetrator in native country. Relationships often started out with perpetrator being ‘kind and sweet’ but emotional abuse, in the form of threats to report applicant to immigration or keep custody of children and withholding of finances along with severe physical and sexual abuse occurred within a year of moving to USA. Contact with the police was usually initiated by the victim. Barriers to contacting police included fear of deportation, dependency on abuser, and loss of children. Shelters and victim advocates were the main source of help for women.

Significance

While the U-visa gives the immigrant applicant the possibility of lawful permanent residence, to qualify, the immigrant must overcome fears of deportation and cooperate with the police. The affidavit provides a picture of how the abuse started and offers ideas for prevention and intervention.
COMMUNITIES ARE NOT ALL CREATED EQUAL: DESIGNING ENVIRONMENTS TO PREVENT VIOLENCE
Authors: Tsao B , Davis RA , Cohen L
Published: October 2012

Background

Violence and fear of violence are major factors that cause injury and disability, correspond to increased rates of chronic disease and health disparities, and fundamentally undermine health and well-being.

Aims/Objectives/Purpose

Written for local government agencies and community practitioners, this paper presents evidence that violence is a health equity issue and describes prevention strategies, especially at the policy and systems levels, that promote the development of safe environments for everyone.

Methods

Mixed methods were used, including a literature review on how the built environment and other community-level risk and resilience factors determine the likelihood of violence. It also incorporates practical lessons from seven years of working with U.S. cities to advance a public health approach to prevent youth violence before it occurs.

Results/Outcome

Safety is not fairly distributed in society, and some U.S. communities and groups are far more exposed to the poor neighborhood conditions that give rise to violence. Violence disproportionately affects young people of color and those living in communities that have been subjected to high levels of disinvestment. Because community-level risk and resilience factors for violence are spread unequally, some neighborhoods experience disproportionately elevated rates of injury, disability, chronic diseases from prolonged stress, and other maladies.

Significance/Contribution to the Field

This paper provides concrete evidence that preventing violence requires improving specific factors in community environments, such as in urban neighborhoods. The findings suggest that preventing violence is a critical strategy for sustainably reducing disparate outcomes in injury and premature death, and for achieving equity across diverse communities.
CURRENT EVIDENCE ON PUBLICISED SOBRIETY CHECKPOINT PROGRAMMES: ARE THEY STILL EFFECTIVE?
Authors: Bergen G , Pitan A , Shults RA , Qu S , Sleet DA
Published: October 2012

Background

Alcohol-impaired driving is a major contributor to motor vehicle crash deaths resulting in almost 270 000 deaths globally. In 2001, the Community Preventive Services Task Force recommended the use of sobriety checkpoints on the basis of a systematic review that showed sobriety checkpoints resulted in a median decline of about 20% in alcohol-related crash fatalities. This review included 32 studies published through 30 June 2000. New studies evaluating publicised sobriety Checkpoint programmes have since been published, leading to an updated review in 2012.

Aims/Objectives/Purpose

To determine if the effectiveness of sobriety checkpoints has changed since the publication of the 2001 (original) systematic review.

To explore whether low manpower staffed checkpoints are as effective as traditional checkpoints.

To determine the economic costs and benefits of sobriety checkpoints.

Methods

The Community Guide methods for systematic reviews were used to evaluate studies of sobriety checkpoints published from July 2000 through March 2012.

Results/Outcomes

Fifteen studies met the systematic review inclusion criteria. Fourteen studies conducted in the USA showed a median reduction in alcohol-involved fatal crashes of 8.9%. One study from New Zealand showed a reduction in serious and fatal nighttime crashes of 22%. The two evaluations on low manpower staffed checkpoints respectively showed reductions of 18% and 64% in alcohol-involved fatal crashes and drinking/driving behaviour. Five economic evaluations showed that benefits exceed costs with benefit-to-cost ratios ranging from 2 : 1 to 57 : 1.

Significance/Contribution to the Field

This systematic review update confirms the effectiveness of sobriety checkpoints in reducing alcohol-impaired crashes, injuries and deaths.
EVIDENCE OF THE ROLE OF CCTV IN PREVENTING ALCOHOL-RELATED ASSAULTS IN A NIGHT TIME ECONOMY
Authors: Pointing SB
Published: October 2012

Background

The number and severity of injuries caused by alcohol-related violence in inner-city entertainment areas is an ongoing concern. Despite continued public investment in CCTV, most previous research has indicated CCTV has little effect in reducing the number of these assaults or associated disorder.

Purpose

This paper builds on a recent publication inInjury Preventionand presents research conducted as part of a broader community-based study aiming to reduce alcohol-related assaults in the night-time economy of Cairns, Australia.

Methods

Semi-structured interviews, focus groups and observational sessions in the Camera Room. Footage from 30 cases of assault was examined. A Realist Evaluation framework was used to examine CCTV operations and assaultoutcomes.

Results

CCTV operators directed private security who intervened in 40% (n=12) of assaults, limiting possible injury. This included three incidents judged as preventable. A further five (17%) assault incidents were also potentially preventable. The remainder (43%) happened too quickly for intervention. Salient aspects of thecontextof the CCTV system were defined, and relevantmechanismswithin the camera room and the real-time communication network were postulated or identified.

Significance

Intervention points within these mechanisms are offered for testing, and an assault-related cost–benefit analysis of the CCTV system is presented. These findings are then situated within the overall research programme. This may progress the debate about the effectiveness of CCTV systems in limiting injuries from alcohol-fuelled community violence, and address calls for more sophisticated techniques to evaluate CCTV's effectiveness.
WEB-BASED INTERVENTION FOR MAORI UNIVERSITY STUDENTS WITH HAZARDOUS DRINKING: DOUBLE-BLIND, MULTI-SITE RANDOMISED CONTROLLED TRIAL
Authors: Kypri K , Mccambridge J , Vater T , Bowe S , Saunders JB , Cunningham JA , Horton N
Published: October 2012

Background

Like many indigenous peoples, New Zealand Māori bear a heavy burden of alcohol-related harm relative to their non-indigenous compatriots, and disparities are greatest among young adults. We tested the effectiveness of web-based alcohol screening and brief intervention (e-SBI) for reducing hazardous drinking among Māori university students.

Methods

We ran a double-blind, multi-site, randomised controlled trial. We invited 6697 17–24-year-old Māori students from seven of New Zealand's eight universities to complete a web-based AUDIT-C, a screener for hazardous and harmful drinking. Those screening positive were computer randomised to: <10 min of web-based alcohol assessment and personalised feedback (intervention) or screening alone (control). We conducted a 5 month follow-up assessment with observers and participants blinded to study hypotheses, design, and intervention delivery. Predetermined primary outcomes were: (1) frequency of drinking (2) amount consumed per typical drinking occasion, (3) overall volume of alcohol consumed, and (4) academic problems.

Results

1789 respondents were hazardous drinkers (AUDIT-C≥4) and were randomised: 850 to control, 939 to intervention. Follow-up assessments were completed by 682 controls (80%) and 733 intervention group members (78%). Relative to controls, participants receiving intervention drank less often (RR=0·89; 95% CI 0·82 to 0·97), less per drinking occasion (RR=0·92; 0·84 to 1.00), less overall (RR=0·78; 0·69 to 0·89), and had fewer academic problems (RR=0·81; 0·69 to 0·95).

Significance

Web-based screening and brief intervention reduced hazardous and harmful drinking among non-help-seeking Māori students in a large scale pragmatic trial. This intervention is now being implemented routinely in all New Zealand universities and could be implemented elsewhere. The study has wider implications for behavioural intervention in the important but neglected area of indigenous health.
TARGETED REGULATION OF LICENSED PREMISES IN A CITY ENTERTAINMENT PRECINCT: IMPACT ON ASSAULTS, STREET OFFENCES AND EMERGENCY DEPARTMENT PRESENTATIONS
Authors: Wiggers J , Tindall J , Gillham K , Lecathelinais C
Published: October 2012

Background

Licensed premises in entertainment precincts are associated with higher levels of alcohol-related harm. In 2008, additional licensing conditions were imposed on a number of hotels in the main entertainment precinct of Newcastle, NSW (Australia). These included reduced trading hours, lock-outs, drink restrictions and additional Responsible Service of Alcohol strategies.

Aims/Objectives/Purpose

The aim of this study was to determine the impact of the conditions on night-time assaults, street offences and assault-related injury emergency department presentations 3 years post-intervention.

Methods

Two separate analyses were undertaken:

1. Separate binomial regression analyses were undertaken to assess changes over time in police attended incidents (night-time non-domestic assaults and street offenses) in the study area and three comparison areas for 2001 to 2011.

2. A linear regression analysis with linear and quadratic trends was conducted to model changes over time in emergency department presentations (night-time assault related injury) in four hospitals located within 40 km of the main entertainment precinct for 2001 to 2011.

Results/Outcome

In the 3 years following the implementation of additional licensing conditions in Newcastle, the study found a significant:

• 28% to 37% relative reduction in night-time non-domestic assaults relative to three comparison areas.

• 44% to 70% relative reduction in night-time street offences relative to three comparison areas.

• 26% reduction in night-time assault-related injury emergency department presentations.

Significance/Contribution to the Field

The reduction in alcohol-related harm following the introduction of the conditions and the longevity of such improvements provide strong evidence for the imposition of such licensing conditions.
IMPACT ON HOME STAIRWAY SAFETY REGULATION IN CANADA: WHEN EVIDENCE AND INDUSTRY-INFLUENCED GOVERNMENT POLICY CLASH
Authors: Pauls J , Barss P
Published: October 2012

Background

Since about 1940 the National Building Code of Canada (NBCC) has been produced by the National Research Council of Canada (NRCC). However, in recent decades, home stairway design requirements have not been based on the best available research, including NRCC's own. Injury data for Canada's largest province (Ontario) suggest a rate of hospital-admitted stair-related injuries twice that of the USA (30 vs 15 per 100 000 population).

Objectives

With built environment regulation being a reliable mechanism for stair-related injury prevention, the objective is to improve NBCC requirements.

Methods

Beginning in the mid 1970s, NRCC research staff attempted to work with NBCC-development committees, both to apply what was scientifically known about stairway safety and to encourage new research. Many research-based, code-change proposals were submitted in 1992. In 2011, the International Conference on Stairway Usability and Safety established consensus on research evidence justifying improved requirements.

Outcomes

Key proposals from 1992 have not yet been processed. In 2010, several task groups were formed and many recommendations for code changes, on stairways, were drafted. However, task groups report to a committee that, since the 1970s, has been dominated by home builders highly resistant to changes.

Significance

NBCC-development policies and procedures, increasingly influenced by an industry-dominated Canadian Federal Government, pose old and new impediments to improved home design requirements and reduced, stairway-related injury tolls.
SAFETY AROUND THE HOME: AN INTERACTIVE, EVIDENCE-BASED GUIDE TO CREATING A SAFE HOME ENVIRONMENT
Authors: Tyson S , Austin E , Laughlin A , Green J , Minuzzo B
Published: October 2012

Background

The Raising Children Network (RCN) specialises in the translation of scientific research and best-practice online support to parents of children 0–18 years through its website, social media and mobile technologies. With approximately 500 000 visits to the website per month, it is a trusted, evidence-based parenting resource that incorporates injury prevention information to increase parent knowledge on how to provide a safe environment for children and reduce injury and hospitalisation rates.

Aims

The injury prevention interactive project aims to deliver engaging evidence-based information to parents/carers to provide children with a safe environment for learning and development by ameliorating potential risks.

Methods

Parent/carer education is done through an online interactive tool on the RCN website. The home safety tool allows parents to explore an interactive home and surrounds and is engaging and enjoyable to use. Parents can filter by age group so that appropriate safety issues are shown. As users explore each interactive area they click on highlighted issues to learn about the hazard and how to prevent burns, poisonings and other injuries via on screen text, downloadable information and videos. When they have finished exploring the house, parents generate a checklist of all actions they need to make in the home.

Results

A demonstration of the evidence-based interactive will include a tour of the virtual house where parents explore and fix safety issues around the home. The virtual tour allows parents to develop a checklist of the actions they need to complete in their own house with a view to creating a safe environment.

Significance

The home safety tool facilitates interactive learning for parents through a web-based intervention. Video content will allow us to reach a wider audience including those with learning difficulties and non-English speaking backgrounds and also show parents the ‘HOW’ of home safety instead of simply telling them ‘WHAT’ to do.
HOME INJURY HAZARDS AND HOME INJURY IN NEW ZEALAND
Authors: Keall M , Baker M , Howden-Chapman P , Cunningham M , Cunningham C
Published: October 2012

Background

Although the home is a major setting for injury morbidity and mortality, there are few proven effective interventions for reducing home injury risk.

Aims

To develop measurement protocols for assessing home injury hazards and practical procedures for making targeted repairs to these hazards.

Methods

We developed the Healthy Housing Index as a protocol for systematically quantifying the degree of risk posed by housing to the health and safety of the occupants. We studied in detail a large number of home injuries to identify likely preventive measures focused on structural aspects of the home environment.

Results

Approximately 38% of the 1328 home injuries studied were potentially associated with modifiable features of the home environment. We also found a statistically significant association between increasing numbers of home injury hazards and the occurrence of home injury, providing qualified evidence for the potential effectiveness of home injury hazard remediation as an effective injury prevention measure.

Significance

The current study potentially provides a path to an effective means to prevent home injury. The expense of making repairs to home injury hazards places greater demands on reliable evidence of the effectiveness of this intervention. This is currently the subject of a large randomised controlled trial, currently in progress.
THE EPIDEMIOLOGY OF CUTTING OR PIERCING INJURIES AT HOME AMONG YOUNG AND MIDDLE-AGED ADULTS
Authors: Kool B , Sharpe S , Robinson E , Ameratunga S
Published: October 2012

Background

Unintentional injuries in the home account for a significant burden of injury among all age groups. Cutting or piercing injuries are the second leading cause of injury hospitalisation in New Zealand. The impact of injuries at home among young and middle-age adults may have significant implications for both work productivity and family life.

Aims/Objectives/Purpose

To explore modifiable risk factors for unintended cutting or piercing injuries at home among 20–64 year olds.

Methods

A population-based case-control study was conducted in three regions of New Zealand (August 2008–December 2009). Cases were 356 people aged 20–64 years admitted to hospital in the regions as a result of a non-occupational unintentional cutting or piercing injury at home. Controls were 839 individuals of the same age randomly selected via telephone using a Computer Assisted Telephone Interviewing (CATI) system. An interviewer-administered questionnaire elicited data on a range of putative risk and protective factors.

Results/Outcomes

After adjustment for major confounders, the risk of cutting or piercing injuries was significantly increased with the consumption of three or more standard alcoholic drinks in the previous 6 h compared with the consumption of none (OR 3.93; 95% CI 1.61 to 9.57); chronic fatigue (OR 1.87; 95% CI 1.11 to 3.14); and marijuana use in the past year (OR 2.37; 95% CI 1.18 to 4.77).

Significance/Contribution to the Field

Interventions that address the risk factors identified are indicated. While the risks associated with drink driving are well recognised, the potential injury risks associated with hazardous drinking at home requires greater attention.
PACIFIC PROVIDER MAKING A DIFFERENCE
Authors: Timmins C
Published: October 2012

Background

Pacific people are overrepresented in injury statistics in New Zealand and injury contributes to significant disparities in health for our Pacific communities.

Waitakere has a long history of working with Pacific communities and providers to raise awareness of injury and build a culture of safety among Pacific peoples.

Aims/Objectives/Purpose

To focus on the home environment using a more holistic view of safety across health, injury, housing and immigration, with the understanding that for Pacific families cultural and emotional safety are as vital as physical safety from injury.

Methods

Working with our local Pacific health provider using a collaborative framework, positive staff engagement was achieved. Staff continued to participate in the development of a robust home safety checking system which was implemented and reviewed over a 3 year period. An agreed process covering recruitment of families to the programme, a systematic delivery method, options for remediation of issues and a long term review system was developed. Significant professional development of staff was undertaken and a plan for integration of the programme into service delivery was implemented.

Results/Outcomes

The final report indicated significant changes in understanding of injury risks, options for remediation and family practice around key risk areas of participating families. This dedicated health provider continues to deliver the home safety checking system as part of their practice.

Significance/Contribution to the Field

This project identified a pathway for injury prevention promotion in a key Pacific health agency, providing a continued process to raise awareness and manage risks with pacific families.
EVALUATION OF A NATIONAL HOME SAFETY EQUIPMENT SCHEME
Authors: Watson MC , Errington G , Hamilton T , Mulvaney C , Smith S , Binley S , Coupland C , Kendrick D , Walsh P
Published: October 2012

Background

The national scheme was established in England in 2009 with £18m, running for 2 years. It targeted families with children under 5 living in areas with the highest accident rates in England. Scheme components included: training for professionals; home safety checks; advice for families; free provision and installation of home safety equipment. The Royal Society for the Prevention of Accidents established and managed the scheme nationally. Delivery was through a range of local organisations. Independent evaluation was conducted by the University of Nottingham.

Aims/Objectives/Purpose

To evaluate the national scheme; specifically investigating effectiveness, appropriateness and reach.

Methods

This complex evaluation employed multiple methods including postal surveys, one-to-one interviews, direct observation, case studies, documentary analysis and postcode mapping of family data.

Results/Outcome

The evidence gathered from a range of sources and perspectives was very positive with regard to the implementation and value of the scheme. A total of 129 local schemes were active covering 92% of the original target areas. Safety equipment was professionally fitted in 66 127 homes and 282 000 families had received home safety information. Mapping the postcodes for families in receipt of equipment confirmed that 70% resided in the most deprived areas of England. The distribution of supporting resources included 7881 DVDs, 3885 flipcharts and 568 000 height charts. Feedback from families and professionals was positive.

Significance/Contribution to the field

The evaluation has implications both for future home safety equipment schemes and the evaluation of large injury prevention interventions.
THE ECONOMIC BURDEN OF ALL-TERRAIN VEHICLE-RELATED ADULT DEATHS IN THE US WORKPLACE, 2003–2006
Authors: Helmkamp J , Elyce B , Marsh S , Aitken M , Campbell C
Published: October 2012

Background

All-terrain vehicles are used in a variety of industries and occupations.

Objective

To estimate the societal economic burden associated with occupation-related ATV fatalities among civilian persons more than 17 years of age in the USA from 2003–2006.

Methods

ATV death data were obtained from the Bureau of Labor Statistics' annual Census of Fatal Occupational Injuries. Costs were estimated using a model employing a cost-of-illness method developed by the National Institute for Occupational Safety and Health.

Results

From 2003–2006, 129 occupation-related ATV deaths occurred among persons >17 years of age in the USA, nearly doubling from 20 deaths in 2003–39 deaths in 2006. The collective lifetime cost of the deaths was $103.6 million (M) with a 4-year mean of $803 100 and a 4-year median of $772 100. Decedents aged 35–54 years accounted for one-third of the deaths (n=41) at a cost of $50.1 M. Montana had the most deaths (13). Fifty-two per cent of the deaths were overturns costing $48.3 M. Eighty-four (65%) of the deaths were workers in agricultural production at a cost of $62.3 M.

Significance

Short-term investment in prevention measures, such as training and helmets for workers, could provide lasting dividends by preventing occupation-related ATV deaths and reducing their economic impact.
A FAMILY INTERVENTION TO INCREASE THE USE OF SEATBELTS ON ROPS TRACTORS
Authors: Stoneman Z , Jinnah-Ghelani H , Rains G , Brightwell B
Published: October 2012

Background

Almost all tractor roll-over fatalities can be prevented by the use of safety equipment such as Roll-Over Protection (ROPS) and seatbelts. Unfortunately, many farmers still do not wear seatbelts on ROPS tractors.

Aims

This is part of a larger NIOSH-funded study utilising the Theory of Planned Behavior to evaluate a family-based farm safety intervention. This presentation focuses on wearing seatbelts on ROPS tractors.

Methods

This research utilised a longitudinal, randomised-control design including two intervention groups (primary farmers or safety experts as teachers) and a no-treatment control. Lessons were taught to the whole family. Almost all primary farmers were fathers. Data were collected from the whole family. Data reported in this presentation were from 115 families.

Results

ANCOVAs revealed that, after controlling pre-intervention levels, farmers in the primary farmer-led group were less likely to have unsafe behaviours and intentions related to operating ROPS tractor without a seatbelt than those in the safety expert or control group. Both intervention groups reported a positive change in attitudes and risk awareness as compared to the control group. Youth in primary farmer-led group reported a positive change in behaviour compared to control group. Groups did not differ in intentions and risk awareness.

Significance

When primary farmers are involved in teaching their families about farm safety, it has a positive impact on their own behaviours and intentions as they see themselves as models for their youth. Findings help us create effective interventions that impact behavioural change in fathers and youth related to farm safety.
GPS TRACKING OF QUAD BIKE USE ON AUSTRALIAN DAIRY FARMS
Authors: Lower T , Trotter M
Published: October 2012

Background

Available data on quad bike use in Australia is limited by the subjectivity of self-report.

Aim

This study sought to ascertain the pattern of usage by geospatial techniques in a small sample of Australian dairy farmers and compare this to self-reported data.

Method

The quad bikes of 11 dairy farmers were fitted with two GPS units for a period of 14 days. High temporal resolution data was collected to determine speed by recording five locations 15 s apart at 5 min intervals for the first 2 days. Data from the 14-day period (with single locations recorded every 5 min), were used to assess usage patterns and exposure. These data were compared to self-report data obtained prior to and immediately following the test period.

Results

The majority of usage was at speeds less than 10 km/h (80%), with the average speed being 9 km/h. This compared to the self-reported mean of 19 km/h. Other calculations of rider exposure were also attained.

Significance

This is the first study to objectively report on speed and rider exposure in Australian dairy farmers. In general terms average speeds defined by self-report were over-estimated by 10 kmph. The predominance of low speed use has implications for the type of helmets required on dairy farms. Further, this may provide an opportunity to increase helmet use compliance and reduce head injury.