bluuebunny/crossref_metadata_2025_split huggingface dataset:
Demographic risk factors of self-immolation
Authors: Ahmadi A , Mohammadi R , Schwebel D C , Khazaie H , Yeganeh N , Almasi A , Kassani I 
Published: March 2011

ObjectiveTo investigate demographic risk factors for self-immolation patients.MethodsIn a case–control study, 30 consecutive cases of deliberate self-inflicted burns admitted to the regional Burn centre (Imam Khomeini hospital in Kermanshah province, Iran) were compared with 30 controls who were selected from the community and matched by gender, age and living area. All cases and controls were reviewed for demographic variables, including: age, gender, living area, family size, marital status, bearing and number of children, body mass index (BMI), birth order, employment state, educational status, early school drop-out and parent/guardian employment status.ResultsTwo variables emerged as related to risk of self-immolation. Being the first or last child in family birth order was associated with increased risk of self-immolation. Moreover, among the married participants, having children was associated with decreased risk of self-immolation. The comparisons of other variables were not statistically significant. In multivariate analyses, none of the variables predicted risk for self-immolation.ConclusionThis study suggests that being the first or last child of a family might be a risk factor for self-immolation. For married persons, having children might serve as a protective factor from self-immolation. Other variables such as family size, marital status, number of children, BMI, employment state, educational status, early school drop-out and parent/guardian employment status did not play a role as individually protective or risk factors for self-immolation.
What defines the trend of violence-related injuries?
Authors: Rozenfeld M , Peleg K 
Published: March 2011

BackgroundPrevious studies established a clear connection between unemployment and violence rates trends, but little is known about influence of such factors on trends in severity of violence-related injuries. As the severity of those injuries is known to be connected to types of violence, this study will look for correlation between the trends of all abovementioned factors.MethodsA retrospective study based on the National Trauma Registry data on patients hospitalised between 1 January 1998 and 31 December 2006 due to trauma. It consisted of 167 142, patient records of which 9839 (5.9%) sustained violence-related injury. Descriptive statistics and bivariate analyses were used to characterise trends and injury patterns.ResultsUnemployment trend had a significant correlation with violence rates and stabbing trends, but no connection to injury severity trend was found. Injury severity trend correlated positively with firearms trend and negatively with ‘unarmed brawling’ trend. Stabbing trend correlates negatively with firearms and ‘assault with an object’ trends. Despite polar differences in injury severity between stabbing and firearms, both types of violence have similar distribution in most demographic groups in distinction from ‘unarmed brawling’ and ‘assault with an object’.ConclusionsDespite the connection to violence rates and stabbing, unemployment has no linear connection to the severity of violence-related injuries. Nevertheless, the correlation of stabbing trend with firearms trend, which, in turn, had strong correlation with injury severity trend, suggests that a non-linear relationship could be present.
Assessment of patient safety culture in hospitals of Hyderabad, India
Authors: Tetali S , Kannuri N K , Rao M 
Published: March 2011

BackgroundThe setting of this work is Andhra Pradesh (AP), the fourth largest state Indian state with 76 million people in which the AP patient safety alliance was recently launched. This paper describes the results of assessment of patient safety culture in select hospitals of Hyderabad during September– November 2009.AimTo understand the safety culture of hospitals in Hyderabad, to assess current levels of implementation and barriers to two of the Global Patient Safety Challenges, Clean Care is Safer Care Safe Surgery Saves Lives.MethodologyThree government and four private hospital superintendents, doctors, nurses, occupational therapy staff and ward boys participated in the study. In depth interviews, focus group discussions, structured questionnaires and facility audits were conducted. Data was analysed with SAS.ResultsHand hygiene preferences were variable. Some used hand rubs because they are less messy than soap, but others objected to strong smell of hand rubs. Hospitals locally adapted checklists for surgical procedures with private hospitals having more elaborate checklists, and government hospitals, basic ones. 60% thought their hospital is doing more for patient safety now, than last year. 25% were unable to express disagreement with physicians. Most errors here are due to ego problems and communication gaps between departments –nurse and barriers to implementation: high attrition rate and need for constant training (private hospitals), severe shortages of staff (government hospitals).ConclusionManagement support and leadership are crucial in implementing patient safety. Private hospitals adhere to protocols better than government hospitals in Hyderabad, which are grappling with more basic problems like staff shortage.
Comparison of return to work outcome measures following transport injury
Authors: Collie A , Brion A , Barker S , Johnstone R , Pennay D 
Published: March 2011

BackgroundReturn to work (RTW) is an important marker of recovery from injury. There is substantial evidence that RTW is associated with higher levels of self-rated health, quality of life, greater social inclusion and reduction in ongoing disability. There are multiple RTW metrics reported in the literature and little consensus regarding the most appropriate.AimTo compare RTW rates following transport injury using a number of criterion.MethodSix-hundred and one individuals (328 males) injured in a transport accident completed a telephone survey between 6 months and 10 years (mean 3.5 years) post injury. Four hundred and forty participants (73.2%) were working at injury, with 289 (48.1%) working >35 h per week.Results69.4% of those working at injury had achieved any RTW since injury, with fewer currently working (59.2%) or achieving sustained (57.6%), current and sustained (54.1%) or full RTW (37.6%). RTW rates were greater for those working >35 h per week prior to injury, with 86.9% achieving any RTW and 45.7% achieving a full RTW (defined as >35 h employment per week). In contract, rates in those not working prior to injury were much lower, with 29.2% achieving any RTW and 16.1% achieving a full RTW. RTW rates also varied significantly according to time post injury and occupation.ConclusionConclusions regarding injury recovery can vary greatly depending on the RTW criterion utilised and sample characteristics.
Injury surveillance in Tarija, Bolivia
Authors: Zavala D 
Published: March 2011

An injury surveillance system has been established at Hospital San Juan de Dios in November 2009, in the city of Tarija, Bolivia. This is the main hospital for the city that received close to 90% of all injury cases that require emergency service and/or hospitalisation. Therefore the data collected at this hospital can well reflect the occurrence of injuries in the city of approximately 171 000 people. Based on a 2003 health survey, 68.6% of those interviewed reported a previous incident of interpersonal violence.We report on an analysis of the first 9 months of data collection (December 2009–August 2010) for the three most frequent injuries treated at the hospital emergency department: intentional injuries such as interpersonal violence, child and elderly abuse, youth violence, self-inflicted violence and road traffic injuries.
Kenyan village children affected by bacterial meningitis
Authors: Nyabade G 
Published: March 2011

ObjectiveKenyan village children are casualties to bacterial meningitis. Early diagnosis and appropriate antibiotic treatment are perhaps the most important initiatives towards eradication of this great pandemic and its management in Kenyas rural villages. The objective of this study indicates and brings to awareness that bacterial meningitis kills many children from poor and desperate Kenyan villages without access to hospitals or clinics.MethodsNyando Sub District Hospital, serving 300 000 people in a rural, malaria-pandemic area of the Western Kenyan, was studied. A Kenya Medical Research Institute research centre is located at Kisian near Kisumu city. All paediatric admissions aged 60 days between June 2001 and July 2002 were eligible.ResultsA total of 91(2.0%) of 4582 admissions had meningitis, including 77(4.0%) of 1929 of those who met the IMCI referral criteria for meningitis at admission (sensitivity: 85%; specificity: 59%). Independent indicators of the presence of meningitis were a bulging fontanel, neck stiffness, cyanosis, impaired consciousness, partial seizures and seizures outside the febrile convulsions age range. The area under the receiver operating characteristic curve for a set of simple screening rules based on the positive indicators identified was 0.88(95% CI 0.85 to 0.92).ConclusionsThe presence of one of a bulging fontanel, neck stiffness, cyanosis, impaired consciousness, partial seizures and seizures outside the febrile convulsions age range is a clear indication for lumbar puncture and/or presumptive treatment.
Development of an instrument that assesses individual's burn prevention knowledge
Authors: Lehna C , Myers J 
Published: March 2011

BackgroundCurrently no valid and reliable instrument to assess an individuals burn prevention knowledge exists. Therefore, it is difficult to evaluate if interventions to increase burn prevention knowledge are effective. Therefore we aimed to develop and test an instrument that assesses individuals burn prevention knowledge. As a result, the effect of interventions aimed to increase burn prevention knowledge can be investigated.MethodsA focus group comprised of 22 American Burn Association burn prevention committee members first prioritised areas that individuals with burn prevention knowledge should be well informed about (ie, scalds, gasoline elders, abuse, juvenile fire setters). Then questions were developed to assess an individuals knowledge in these priority areas (39 questions) by the author and tested for reliability and validity. Factor analysis techniques were utilised to develop the final survey (15 questions). The final survey was administered and tested in a group of paediatric, emergency department and clinic nurses for reliability and validity.ResultsFrom the original survey (39 questions), the factor analysis suggests that 15 questions strongly load on a factor and explained 76% of the variance in responses. The five factors with eigenvalues greater than 1.0 were as follows: scalds, gasoline, elders, abuse and juvenile fire setters. These 15 questions represented the final survey to be administered to evaluate burn prevention knowledge in nurses. The final survey developed has moderate inter-rater reliability (Cohens κ=0.578), high intrarater reliability (ICC=0.713) and good internal consistency (Cronbach's α=0.604. In addition, the final survey was determined to have face validity as well as construct validity (five components had eigenvalues greater than 1.0).ConclusionsThe survey developed is positioned to be tested in a multi-site, multi-state and multi-investigator study. If results from this study hold consistent the survey developed can be used in future interventional studies aimed to increase burn prevention knowledge.
Low-cost and sustainable improvements in injury surveillance in Ghana
Authors: Adofo K , Donkor P , Afukaar F , Boateng K , Mock C 
Published: March 2011

IntroductionMortuary data are incomplete in many developing countries. Small investments could lead to substantial improvements.ObjectiveTo evaluate recent trends in injury reporting systems. To identify ways to strengthen the reporting systems and make them more useful for injury control.MethodsWe evaluated changes in data quality on fatally injured persons at KATH over a 12-year period.ResultsDuring 1994–95, cases in KATH's mortuary logbooks had missing information on cause of death, and only 70 injury deaths/year were reported. This was felt to be a gross under-estimate of injury among Kumasi's 1 000 000 people. A pilot program hired part-time nurses to improve recording of injury deaths. During 1996–1999, 633 deaths/year were recorded, more accurately reflecting injury's toll in Kumasi. To assess the sustainability of this improvement after funding expired, we re-assessed mortuary injury data quality in 2006. Reporting remained high, with 865 fatally injured cases recorded. However, only 80% of these cases were found in mortuary logbooks. An additional 20% were found in supplemental sources in the hospital, principally the ICU. Data quality had diminished slightly.ConclusionIn many developing countries, important information is not recorded. Low-cost improvements could lead to improved reporting and data quality. This study has shown that such improvements are sustainable after the initial investments. Minor problems such as insufficient collation of data from multiple sources and coding of mechanism could be corrected by improved organization and training.
Barriers to participation in violence prevention programming: an IPPNW communications survey
Authors: Valenti M 
Published: March 2011

IntroductionInternational Physicians for the Prevention of Nuclear War sought data on potential communications and technology barriers to health professional participation in its global program.Aiming for PreventionA Health Approach to Preventing Injuries from Violence.Materials and MethodsIn consultation with an expert at the University of Delaware, IPPNW developed a 14-question survey focusing on communications issues. It was pretested with six staff at the IPPNW central office, revised, retested with a small group of international medical students, revised again and distributed throughout IPPNW affiliates working on violence prevention, primarily those in the global South in Latin America, South Asia and Africa.Selected ResultsIt was returned by 21 people from 10 countries. About 25% don't own a computer; about 24% only have access to a computer and Internet at a cybercafe; slow/unreliable connections, cost are major impediments to regular internet use; lack of privacy/security issues were also cited; less than half have access to presentation projectors; a majority say that providing them with hardware, software and training of various sorts would help them participate more in IPPNW's violence prevention work.ConclusionsProvision of modern and accessible communications technology would help remove some barriers to easy and full participation by affiliates in IPPNW's violence prevention work. Survey results provided a better understanding of the resources needed to more fully engage busy medical and health practitioners who live and work in the global South.
Distribution of injury death and outpatients in rural and urban areas of China in 2006
Authors: Duan L , Deng X 
Published: March 2011

ObjectivesTo know the distribution features of injury of Chinese population in rural and urban areas, and further to provide basic scientific data for injury prevention and control in different areas.MethodsFatal injury data were derived from official death certificates by the National Disease Surveillance Points System (DSP). Hospital injury visit data were from emergency and outpatient rooms of the 126 hospitals of the National Injury Surveillance System (NISS). Descriptive analysis was used to explore the differences between and similarities in rural and urban areas.ResultsWhile the order of the five main causes of injury deaths were the same in rural and urban areas, mortalities of injury and main types of injury were higher in rural areas than urban areas in 2006. Most of the hospital injury visits from emergency and outpatient rooms were male, 15–64 years old both in rural and urban areas in 2006. The cause or mechanism, location, activity and intent of injury and the clinical conditions of injury patients have both differences and similarities in rural and urban areas.ConclusionThe epidemiologies of both death and hospital visits from injury are different between rural and urban areas in China according to the national surveillance systems. Thus, appropriate strategies and schemes should be taken in injury prevention and control in different areas.
Health system preparedness for road traffic accidents in a rural district in Kerala, India
Authors: Asheel B M , Soman B , Kuriakose V G , Francis S , Mathew T 
Published: March 2011

ObjectivesTo assess the health system preparedness with regard to road traffic accidents, in terms of resources, organisational functions and geographical distribution of trauma care facilities and their proximity to accident prone areas in Alappuzha district, Kerala.MethodsThe WHO Guidelines for Essential Trauma Care was used for this descriptive operational research involving 49 hospitals in Alappuzha district. Site visits were done (Jul–Sep 2009) for direct inspection and interviews with administrative and clinical staff. The geo-spatial data collected was analysed using ArcGIS version 9.1 and adequacy of resources analysed using SPSS version 17.0.ResultsNone of the hospitals at any level had adequate physical or human resources deemed essential at that level as per the guidelines. Though essential physical resources for emergency resuscitation of accident victims were adequate at tertiary level, these were found inadequate (82.4%) or absent (11.8%) even at specialty hospital. In all settings there was a dearth of administrative functions to ensure quality trauma care. Geo spatial analysis showed that 67% of accident prone areas fell within 10 min travel time by an ambulance, to a specialist hospital and 76.5% of specialist hospital falls within 1 h travel time to tertiary hospital.ConclusionTrauma care preparedness of Alappuzha district was found to be dismally poor. The study identified critical resources which if provided would improve the trauma care preparedness in the district several folds without much financial investment. This may suit to similar political and resource poor settings else were.
Providing prehospital trauma care for road traffic injury victims in Iran: a qualitative study of Barriers and facilitators
Authors: Bidgoli H H , Hasselberg M , Khankeh H , Khorasani-Zavareh D , Johansson E 
Published: March 2011

BackgroundRoad traffic crashes are a major cause of death and injury, especially in low and middle-income countries (LMICs). Improvements in prehospital trauma care can help minimise mortality and morbidity from road traffic injuries (RTIs) worldwide, particularly in LMICs with a high rate of RTIs such as Iran. The aim of current study was to explore barriers to and potential facilitators for providing effective prehospital trauma care for RTI victims in Iran based on the experience and perception of prehospital trauma care professionals.MethodsThis study conducted using a grounded theory approach. Participants of the study were 15 prehospital trauma care professionals. The data collected via indepth interviews and were analysed using the constant comparative method. Results Seven categories emerged through data analysis: (1) administration and organisation, (2) staff qualifications and competences, (3) availability and distribution of resources, (4) communication and transportation, (5) involved organisations, (6) laypeople and (7) infrastructures. The lack of interaction and common understanding was identified as the core category. Moreover, a conceptual model was developed based on the categories.ConclusionsAccording to the findings, improving the interaction within the current prehospital trauma care system and building a common understanding of the role of the emergency medical services were identified as the key issues for developing an effective prehospital trauma care system in the country.
Evaluation of random drug tests among public vehicle drivers of Iran
Authors: Motevalian S A , Shirzad H , Jahani M R 
Published: March 2011

Road traffic injuries and opioid use-related mental disorders were the first and fifth cause of burden of disease in 2003 accordingly. In 2007, a media campaign was carried out to notify the public drivers about random drug tests in roads of the country. The objective of this study was to assess the results of random drug test among large vehicle drivers before and after this campaign.MethodsTwo different national roadside surveys were conducted on 1168 and 680 drivers in 2002 and 2008 respectively. In both studies, the subjects were bus and truck drivers and their urine samples were tested by a rapid morphine test at study sites and positive samples were transferred for thin layer chromatography.ResultsIn 2002, 168 drivers out of 1168 (14.4% 95% CI 95% 12.4 to 16.4) were found to have positive morphine test. The second roadside survey which was conducted after media campaign showed that this proportion has decreased to 9.0% (95% CI 95% 7.0 to 11.4).DiscussionOpioid use among large vehicle drivers is a major public health and road safety issue in Iran which needs more attention. Random drug test supported by a media campaign seems to have promising effects on reducing driving under influence of drugs.
National burden of injuries and violence: a household survey in Egypt
Authors: Hafez M , Saad R , Jaffar H S , Gururaj G , Elhennawy H 
Published: March 2011

IntroductionIn 2008, Injury was ranked as the 5th leading cause of mortality and 3rd cause of hospitalisation in Egypt. The aim of the survey was to identify the burden and characteristics of injuries through a population based survey.MethodsA population-based survey was undertaken in five governorates of Egypt through a multi stage probability proportional to size sampling method. A validated semistructured questionnaire was used and information was collected on socio-demographic characteristics, external causes, risk factors for road crashes, outcome, impact and utilisation of healthcare.ResultsInterviews were conducted in 11 118 households and 47 797 individuals were covered during the period March–July 2009. Injuries accounted for 20% of deaths in the surveyed regions. The highest injury mortality was among men and in younger age groups (<45 years). Road traffic injuries were the leading injury cause of death constituting for 56% of deaths with an age adjusted mortality of 20/100 000 population. Road traffic injuries and falls, one-third each, predominated non-fatal injuries, 35% and 34%, respectively. Nearly half of RTIs occurred on the highways. Pedestrians and vehicles drivers were involved in greater numbers of road crashes to the extent of 41% and 40%, respectively. Seat belt usage rate was only 40% and helmet usage rate was <5%. Nearly half of all fall injuries occurred at home.ConclusionsRoad, home and work safety needs to be addressed within the national policies and programmes and through intersectoral approaches.