bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pilot study on home injury risk assessment in two low-income communities in Karachi, Pakistan
Authors: Uzma Rahim Khan , Aruna Chandran , Nukhba Zia , Cheng-Ming Huang , Sarah Stewart De Ramirez , Junaid Abdul Razzak , Adnan Ali Hyder 
Published: October 2012

BackgroundHome is the most common place for non-fatal injuries in children less than 5 years of age. This is due to the time young children spend at home and their exposure to many potential home hazards. However, there are no locale-appropriate tools to assess injury hazards.ObjectiveTo pilot an in-home all injury hazard assessment tool and to identify potential injury hazards in a low-income setting.MethodsTwo neighbourhoods were mapped, and families with at least one child between the ages of 12 and 59 months were identified. Using existing available home injury risk information, an in-home injury risk assessment tool was drafted and tailored to the local setting. Home injury assessments were done in June and July 2010 after obtaining informed consent.ResultsFive hundred and three households were enrolled. Around 75.4% of mothers were educated through at least intermediate school (grade 12). The most common fall risk was stairs without a gate/barrier (50%). Uncovered pools of water presented a drowning risk in 22% of households. Stoves (56%) and matches (44%) were kept within reach of the child representing burns risk. Poisoning risks included cleaning supplies (34%), and medicines (15%) accessible to the child. First aid box with any one basic item was present in 70% of households.SignificanceThis was the first time that an in home all injury risk assessment tool can be tailored and applied in the context of low-income developing country. Risks for childhood falls, drowning, burns, and poisoning are present in low-income housing communities in Pakistan.
Road traffic injuries in urban Pakistani children and adolescents age, gender and road user perspectives
Authors: Uzma Rahim Khan , Junaid Razzak , Rashid Jooma , Lucie Laflamme 
Published: October 2012

BackgroundMore than 9 in 10 children deaths in the road traffic environment occur in low and middle countries. Little is known about the demographic distribution of those deaths and the categories of road users at risk by age and gender. This study sheds light on those issues in one large urban setting of Pakistan.MethodsThis is register-based cross-sectional study in which we extracted all injuries sustained by children aged 1–19 years (n=32 814) from hospital based injury surveillance system (five participating hospitals) in the city during 2007–2010. The injury distributions by category of road users was examined considering age group (1–4, 5–9, 10–14 and 15–19 years), gender and injury outcome (discharge, admission and death). We considered both vulnerable road users (pedestrians, drivers and passengers of two wheelers, drivers) and protected one (passengers of three or more wheelers).ResultsWhereas RTIs among boys increased with age, they peaked among girls at age 5–9 years, for a global male to female ratio of 6 : 1. Children were most often injured as vulnerable road users. In early age groups, children were injured mostly as pillion riders (1–4 years) and as pedestrians (5–9 and 10–14 years) while in older age group (15–19 years), girls as motorcycle passengers and boys, as motorcycle drivers. Pedestrians' injuries had highest admissions (38%) and deaths (46%) in children.ConclusionAt all ages, boys are more injured in road traffic crashes than girls. Both genders are at higher risk as vulnerable road users.
Cross-sectional study of injuries among school children in Ismailia governorate, Egypt.
Authors: Hesham El-Sayed , Fatma Hassan , Suzan Gad 
Published: October 2012

ObjectivesTo determine the pattern and risk factors of injuries among school children in Ismailia city, Egypt.MethodologyCross-sectional school-based study of five randomly selected preparatory schools (Grades 6–8) in Ismailia governorate. Data were gathered by special form filled in by trained interviewers. It included questions about nature, cause and circumstances of injuries that needed medical care or caused activity restriction during the last 6 months.ResultsThe study included 1303 students from the five selected schools. The mean age of the studied pupils was 12.6+1.1 years. The most common external causes of injuries sustained by the pupils were falls (26%), road traffic accidents (23%), and burns (14%). Intentional injuries represented 4.3% of all injuries. Gender played significant role in determining the nature of injury. Most of injured pupils were treated in the outpatient's clinics and discharged home, wile 19% of them were admitted to hospitals. Trauma caused transient disability for 40% of the injured pupils, while it caused permanent disability in 1% of them.Conclusions and RecommendationsInjuries are important health problem among school children in Egypt. They were the cause of significant morbidity and disability, important cause of school absence, and has significant burden on health facilities in Egypt. Therefore, there is need to initiate national programme for identification and prioritisation of the common injuries and their risk factors that can help in the design of injury prevention and control programme. We recommend applying an educational programme targeted at injury prevention among school children in Egypt.
Arnon's model: the use of behaviour change process to reduce violence amongst youth
Authors: Namprasert Pol. Col. Arnon 
Published: October 2012

BackgroundYouth trends of physical fighting and abuse, motorcycle gangs, and rock throwing as a form of attack is dangerous and can cause injury. These growing trends are becoming more violent each year. A recent survey conducted at Khao Suan Kwang District, Khon Kaen Province in Thailand found that 600 people, the majority youth, were injured in 1 year due to violence. Traffic accidents were the main cause of injury, and bullying was a minor cause. Arnon's Model was, therefore, designed to reduce youth violence by using behaviour change process.MethodsData were obtained from four phases in the Arnon Model. First, participants aged 15–25 years were selected based on their involvement in activities such as motorcycle and bullying gangs. Second, participants were trained as the military for 5 days to develop discipline and strengthen self-responsibility. Third, they were provided hands-on experiences to change their attitude, such as visiting prisoners or patients injured from accidents. Fourth, behaviour change was encouraged through community service volunteering.ResultsArnon's model was effective in changing behaviour amongst at-risk youth at Khao Suan Kwang District. Youth violence was reduced by more than 70%.ConclusionThe effectiveness of Arnon's model has been extended to 10 other provinces. It has also effectively reduced drug use among youth.
Now I lay you down to sleep: reducing suffocation risk in the infant sleep environment
Authors: Schnitzer P , Covington T , Dykstra H 
Published: October 2012

BackgroundSuffocation is the leading cause of injury death among infants in the USA. Infant suffocation mortality rates increased from 2.8 to 12.5 deaths/100 000 live births between 1984 and 2004. This increase has coincided with a decrease in sudden infant death syndrome (SIDS) and an increase in infant mortality due to undetermined causes.Aims/Objectives/PurposeDescribe the circumstances of sleep-related infant deaths and compare the injury circumstances and risk factors of infant suffocation deaths to those diagnosed as SIDS and undetermined causes to inform epidemiology, prevention and policy.MethodsInfant sleep-related deaths that occurred from nine states between 2005 and 2008 were analysed. Logistic regression analysis was conducted comparing suffocation deaths to SIDS and undetermined cause deaths.Results/OutcomesA total of 3136 sleep-related infant deaths were analysed: 939 (29.9%) diagnosed as suffocation, 960 (30.6%) as SIDS and 1237 (39.5%) as undetermined cause. Infants who suffocated (compared to SIDS) were more likely to be≥8 months old (OR 2.6, 95% CI 1.5 to 4.7), found on their stomach (OR 1.8, 95% CI 1.3 to 2.6), in an adult bed (OR 2.3, 95% CI 1.6 to 3.2) or couch (OR 2.8, 95% CI 1.7 to 4.8). Compared to undetermined cause deaths, infants who suffocated were more likely to be found on their stomach (OR 1.7, 95% CI 1.3 to 2.2), in an adult bed (OR 1.4, 95% CI 1.0 to 1.9) or couch (OR 1.7, 95% CI 1.1 to 2.5).Significance/Contribution to the FieldInjury circumstances and risk factors in infant suffocation deaths differ from SIDS and undetermined cause deaths. These findings offer clues for prevention.
IMPACT OF TAI CHI ON IMPAIRMENT, FUNCTIONAL LIMITATION, AND DISABILITY AMONG PRECLINICALLY DISABLED OLDER PEOPLE: A RANDOMIZED CONTROLLED TRIAL
Authors: Day L , Hill KD , Jolley D , Cicuttini F , Flicker L , Segal V , Stathakis V 
Published: October 2012

BackgroundIntegration of falls prevention with promotion of independence for older people will enhance uptake of effective programs.ObjectiveTo test the effect of tai-chi on both progression of disability and falls prevention in the elderly.MethodsMulti-site parallel group individually randomised controlled trial. Participants were pre-clinically disabled community-dwelling people 70+ yrs (n=503), without major medical conditions or moderate to severe cognitive impairment. Intervention was modified Sun style tai-chi compared with seated flexibility exercise, both programs delivered in groups for 60 minutes twice weekly for 24 weeks. Disability was measured with the Late Life Function and Disability Instrument (LLFDI). Falls were reported using a monthly post-card calendar system.ResultsThere was little effect on disability or falls outcomes. The largest disability difference was in the Disability Limitation Score: mean change was -0.1 and -0.04 points for intervention and control groups respectively (adjusted difference -0.6 95% CI -2.31 to 1.11). Multiple imputation of missing data did not change the result. Falls per 100 person years were 57.7 and 59.6 for intervention and control groups respectively (rate ratio 0.96, 95% CI 0.67 to 1.41). A higher proportion of intervention participants ceased attending the exercise program (difference=17.9%, 95% CI 9.6 to 25.8).SignificanceModified Sun style tai-chi did not impact on disability or falls in pre- clinically disabled older people when delivered for 24 weeks. Withdrawal from the exercise classes was high but did not explain the null result. It is not clear whether improved compliance or a longer or more intensive program would have achieved a better result.
Fall risk and fitness among older adults enrolled in balance and strength training classes
Authors: Goss C , Thoreson S , Harrod C , Clark L , DiGuiseppi C 
Published: October 2012

BackgroundThe fall risk profile of older adults who participate in community balance/strength classes for fall prevention is not well described.Aims/Objectives/PurposeWe examined fall risk and fitness in older adults taking N'Balance™, an 8-week community-based balance/strength programme.MethodsAll 241 first-time participants aged 60+ in 34 consecutive N'Balance programmes held in the study community completed surveys, and staff-administered 30-second chair stand and 8-foot up-and-go tests, during the first and last class. 89% consented to release results to investigators. We calculated fall risk and fitness estimates with Wald 95% CIs. We analysed before-after changes using paired-t or Wilcoxon signed-rank test.Results/OutcomesMean participant age was 75.7 years; 82.1% were female, 96.7% had secondary or higher education, and 26.1% (95% CI 20.5% to 32.7%) had BMI≥30. Half (48.1%; 41.3%, 54.9%) had fallen at least once in the past year. Overall, 79.9% (73.9%, 84.8%) had at least one important fall risk (age≥75, fairly-to-very concerned about falling, frequent ‘near falls’, or fall history). At post-test (83% response), frequency of ‘near’ falls decreased significantly (Z=−6.816, p<0.001); fear of falling (Short Fall Efficacy Scale-International) declined by 0.8 points (p<0.001), 30-second chair stand improved by 1.7 stands (p<0.001), and 8-foot up-and-go improved by 1.1 s (p<0.001).Significance/Contribution to the FieldMost older adults in community balance/strength classes are at high risk of falls, indicating that such classes are successfully reaching those in need of fall prevention. The N'Balance programme decreased self-reported ‘near’ falls and fear of falling, and improved fitness; controlled evaluation of its effect on falls is needed.
Preventing children falling from residential buildings: lessons of success from a working party
Authors: Candace Douglass , Danny Cass , Lauren Cohen , Peter Conroy , Stephen Durnford , Patricia Manglick , Cathy Sherry 
Published: October 2012

BackgroundThe Children's Hospital at Westmead (CHW) has seen an alarming increase in the number of children accidentally falling from windows and balconies. Most of these children suffer serious injuries and, sadly, many of them never recover. Recognising that these tragic accidents are preventable, staff at CHW formed a working party in 2009 to address this important issue.AimThe Working Party for the Prevention of Children Falling from Residential Buildings hopes to see a dramatic reduction in the number of children admitted to hospital as a direct result of initiatives outlined in their report. These initiatives focus on education, awareness, regulatory measures for existing buildings and design standards for new buildings.MethodRepresentatives from government and non-government organisations were invited to join a committee to produce a report, outlining the key issues and providing recommendations to curb this growing problem.ResultsThe formation of a working party consisting of a wide range of professionals has been extremely useful in addressing the issue of Australian children falling from residential buildings. To date, there has been exceptional uptake of the issue within the industry and community and a wide range of changes are already in the process of implementation. Changes to Australian Building Codes have been approved and consultation is currently underway on NSW Tenancy Laws.SignificanceWe believe the model utilised in the prevention of children falling from residential buildings has been extremely successful in garnering support for the issue and pushing for change in a wide range of settings. In particular, the use of a document written by experts in a range of fields has created a model for future injury prevention projects undertaken at CHW.
Built environment safety: epidemiology of head and brain injury and fractures from stair falls in Canada
Authors: Barss P , Hiscoe L , Myers M , Blackett H , Olsen K 
Published: October 2012

BackgroundFalls are overtaking traffic injuries as the leading cause of not only injury hospitalisation, but also death. Stairs are of special interest for prevention by design, being subject to building codes.ObjectivesTo assess importance and determinants of stair as causes of death and hospitalisation in Canada and a major rural-small urban region in the British Columbia interior.MethodsNational and provincial mortality and hospitalisation databases were used to compare determinants and trends of external cause W10 with other falls, grouping nature of injury codes for W10 by head and brain trauma and limb fractures.ResultsIn Canada, stair-related deaths averaged 280/year and 0.9/100 000 person years in 32 000 000 population during 2000–2008, accounting for 63% of inter-level fall deaths, 25% of known and 13% of all fall causes. There were about 10 000 stair-related hospitalisations/year, 36 : 1 hospitalisations:deaths. The British Columbia Interior Health Region had 2586 hospitalisations, 3.5/1000 person years in 750 000 population during 2002–2010; 54% were females, with 46% females and 54% males <65 years-old. Head injuries represented 12% of hospitalisations, extremity fractures most others. Males 5–64-years-old accounted for most severe head injuries, including subdural and epidural haematomas. Stairs were the leading specified cause of head injury, exceeding road crashes.SignificanceStairs are a key built-environment issue, especially for homes. With victims younger than for most falls, disability can be prolonged. Building codes should provide automatic passive protection for all ages by mandating step geometry including deeper treads and short uniform risers, graspable handrails, and high vertical barriers.
Finding balance: using collaboration and evidence to help prevent seniors' falls
Authors: Belton K , Fernandes J , Sunley L 
Published: October 2012

BackgroundAn estimated one in three persons over the age of 65 is likely to fall at least once a year. In 2008 older adults' falls were the leading cause of injury hospital admissions and injury emergency department visits in Alberta, Canada. From 1999 to 2008 there has been a 30% increase in the number of older adults admitted to hospital due to a fall and a 54% increase in the number of older adults seen in an emergency department due to a fall.Aims/Obejectives/PurposeThe purpose of this initiative was to create greater awareness about seniors' falls and promote targeted, evidence-based falls risk prevention messages. It also aimed to connect seniors, families and health care providers to programmes in their communities.MethodsA communications strategy using various tactics, from social media to print advertisements, was developed to promote proven seniors' falls prevention interventions. Tools and resources were also promoted among practitioners.Results/OutcomeSince 2008 when the initiative started we have seen a 13% increase in seniors reporting they are taking actions to prevent falling. An additional 7% of seniors are ‘keeping active’ and a further 9% are ‘watching their step,’ two key messages of the strategy.Significance/Contribution to the FieldFalls prevention among seniors is pivotal to reducing the burden of injury on Albertans. Providing knowledge, tools and support to community stakeholders within a variety of disciplines is a viable method to address falls among seniors, perhaps influencing practice in other injury areas.
Impact of Tai Chi on impairment, functional limitation, and disability among preclinically disabled older people: a randomized controlled trial
Authors: Day L , Hill KD , Jolley D , Cicuttini F , Flicker L , Segal V , Stathakis V 
Published: October 2012

BackgroundIntegration of falls prevention with promotion of independence for older people will enhance uptake of effective programmes.ObjectiveTo test the effect of tai-chi on both progression of disability and falls prevention in the elderly.MethodsMulti-site parallel group individually randomised controlled trial. Participants were pre-clinically disabled community-dwelling people 70+ yrs (n=503), without major medical conditions or moderate to severe cognitive impairment. Intervention was modified Sun style tai-chi compared with seated flexibility exercise, both programmes delivered in groups for 60 min twice weekly for 24 weeks. Disability was measured with the Late Life Function and Disability Instrument (LLFDI). Falls were reported using a monthly post-card calendar system.ResultsThere was little effect on disability or falls outcomes. The largest disability difference was in the Disability Limitation Score: mean change was −0.1 and −0.04 points for intervention and control groups respectively (adjusted difference −0.6 95% CI −2.31 to 1.11). Multiple imputation of missing data did not change the result. Falls per 100 person years were 57.7 and 59.6 for intervention and control groups respectively (rate ratio 0.96, 95% CI 0.67 to 1.41). A higher proportion of intervention participants ceased attending the exercise programme (difference=17.9%, 95% CI 9.6 to 25.8).SignificanceModified Sun style tai-chi did not impact on disability or falls in preclinically disabled older people when delivered for 24 weeks. Withdrawal from the exercise classes was high but did not explain the null result. It is not clear whether improved compliance or a longer or more intensive programme would have achieved a better result.
FIRST EYE CATARACT SURGERY AND HOSPITALISATION FOR A FALL
Authors: Meuleners L , Ng J , Morlet N , Fraser M 
Published: October 2012

BackgroundWith an increasing ageing population, the burden from both visual impairment and falls is expected to increase substantially. Cataract surgery is known to improve vision as well as enhancing quality of life, activity levels and confidence, however, little is known about the impact of cataract surgery on falls.Aims/ Objectives/ PurposeTo assess the association between first eye cataract surgery and hospitalisation from injuries due to a fall in older adults at the population level.MethodsA retrospective population-based study was undertaken using the Western Australian Hospital Morbidity Data System and Western Australian mortality data between 2004 and 2008.Results/ OutcomesOf the 15,295 patients who underwent cataract surgery in one eye only, 600 patients (3.92%) were involved in 625 hospital admissions from injuries due to a fall, either one year before (n=273) or one year after (n=352) first eye cataract surgery. Thirty percent of these hospitalisations were for femoral neck fractures. Poisson generalised estimating equations confirmed a significant increase of 27% (adjusted risk ratio 1.27, 95% CI 1.04 to 1.56; p=0.02) in hospitalisation from injuries due to a fall one year after first eye cataract surgery.Significance/ Contribution to the fieldFirst eye cataract surgery was associated with an increase in hospital admission from injuries due to a fall in the year after, compared to the year before cataract surgery. Further research is needed to determine the underlying causes and reasons.
Community-dwelling older people hospitalised for fall-related injury: characterising high length of stay users
Authors: Vu T , Finch C , Day L 
Published: October 2012

BackgroundNearly half to 60% of falls in community-dwelling older people aged 65+ years result in physical injuries and 20%–50% of these require medical attention, including emergency department visit and hospitalisation. Fallers who stay in hospital longer than would be expected based on the primary injury diagnosis create an excess financial burden on the health system and represent a priority target group for fall prevention.ObjectivesTo identify and characterise high-length-of-stay (HLOS) patients among community-dwelling older people aged 65+ years hospitalised for fall-related injury.MethodsWe analysed hospital discharge data from Victoria, Australia, to identify and characterise HLOS patients among community-dwelling older people aged 65+ years hospitalised for fall-related injury. We defined an episode as HLOS if the length of stay (LOS) was more than three times the average LOS for a particular diagnosis-related group.ResultsBetween 2005/06 and 2007/08 6822 patients (14.2% of the study group of which 73.8% were women) had ≥1 episode classified as HLOS. The HLOS patients accounted for 19.9% of episodes and 39.9% of bed days. HLOS patients were similar to non-HLOS patients in terms of indigenous status, in-hospital mortality and ethnicity. However, HLOS patients were older, less likely to be married, less likely to have hospital insurance and more likely to have comorbidity than non-HLOS patients.Significance/Contribution to the FieldThis study identifies priority groups for a targeted prevention approach.