bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of bicycle injury, head injury, and helmet use among children in British Columbia: a five year descriptive study
Authors: Linn S , Smith D , Sheps S 
Published: December 2008

Objectives and methods—Data on 1462 injured bicyclists aged 1–19, obtained over a period of five years from the British Columbia Children's Hospital as part of a national emergency room based program in Canada, were analyzed to describe the epidemiology of injuries, helmet use, and the occurrence of head injuries before the enactment of a new mandatory helmet law. The odds ratio (OR) and 95% confidence interval (CI) were calculated for non-users compared with helmet users.Results—Bicycle injuries comprised 4% of all injuries seen in the five year study period. The proportion of admissions was 12.7% among bicyclists, significantly higher than the 7.9% admissions of all 35 323 non-bicyclist children who were seen during the study period (OR = 1.96, CI = 1.44 to 1.99). Boys were injured more often than girls. The proportion of admissions for boys was 13.8% compared with 10.2% among girls (OR = 1.41, CI = 0.97 to 2.05). More than 70% of injured bicyclists reported no helmet use. The proportion of admissions of injured bicyclists who did not use helmets was always higher than the proportion of admissions of those who used helmets (OR = 2.23, CI = 1.39 to 3.62). Head and face injuries occurred more often among those who did not use helmets (OR = 1.55, CI= 1.18 to 2.04 ). However, there was no excess of minor head injuries among non-users (OR = 1.10, CI = 0.60 to 2.06). Of the 62 concussions, 57 occurred to non-helmet users (OR = 4.04, CI = 1.55 to 11.47). Most injuries occurred in the upper (46.4%) or lower extremities (32.4%). Dental injuries occurred slightly more often among helmet users compared with non-users but this excess was not statistically significant (OR = 1.29, CI = 0.76 to 2.20).Conclusion—The data indicate the need to control injuries by using helmets. A decrease in the number of head injuries and their severity is expected when bicycle helmet use becomes law in British Columbia.
Impact of a theory based intervention to increase bicycle helmet use in low income children
Authors: Hendrickson Sherry Garrett , Becker Heather 
Published: December 2008

Objective—While community interventions to increase bicycle helmet use have increased markedly, few of these studies are theoretically based. The purpose of this study was to determine relationships among PRECEDE model predictors and self reported helmet use among 407 fourth graders from nine low income, non-urban schools.Setting—Low income schools, with high minority populations in eight non-metropolitan Central Texas counties were chosen.Methods—Schools were randomly assigned in a repeated measures design to either classroom only, parent-child, or control groups. School nurses were educated by the researchers to present a head injury prevention program in all but the experimental schools. Researchers made contact by phone with the parents of children in the parent-child group.Results and conclusions—Participation in either of the educational interventions, followed by belief that helmets protect your head (a predisposing factor), and participation in the parent intervention condition, added significant unique variance to the prediction of helmet use after helmet ownership is accounted. These four variables, taken together, account for 72% of the variance in predicting bicycle helmet use.
Drowning surveillance: how well do E codes identify submersion fatalities
Authors: Smith Gordon S , Langley John D 
Published: December 2008

Objectives—The aim was to determine in New Zealand: (1) to what degree the International Classification of Diseases Supplementary Classification (ICD) external cause (E) codes for drowning identify all deaths involving drowning; (2) how the other drowning deaths are distributed across E codes; and (3) whether the proportion of drownings not identified by traditional ICD E codes has changed over time.Methods—Mortality files for the period 1977–92, which were coded in the range E800-E999 (external causes of injury and poisoning), were searched electronically using the keyword “drown”.Results—2718 cases that involved drowning were identified. This represents a 17.7% increase in the number of cases one would identify using ICD drowning E codes alone. The majority (65%) of the 408 drownings not coded as such were coded as motor vehicle traffic crashes. The number of drownings that were not identified by ICD E codes remained relatively constant over time, although the number of deaths E coded as drowning declined significantly in recent years.Conclusion—Standard ICD E codes for drowning do not identify all drowning related deaths, which may make comparisons of injury rates between countries difficult, especially for injuries such as drownings and burns that can be both nature of injury and external cause codes. Multiple cause coding and the inclusion of free text narratives are an important tool to improve the value of a country's vital statistics for injury prevention, and facilitate comparisons with other countries.
Reported incidence of injuries caused by street glass among urban children in Philadelphia: Table 1
Authors: Makary Martin A 
Published: December 2008

Objectives—First, to assess the incidence and cause of lacerations sustained by urban children from walking outdoors as well as to identify possible means of prevention. Second, to identify the type of health care sought after injury and to measure the extent of glass litter on the streets.Setting—Children (18 years of age or younger) in the Ludlow community of Philadelphia.Methods—A retrospective analysis of lacerations sustained while walking outdoors. A personal survey was conducted with 241 children on a door to door basis. Glass litter was measured by visual inspection of individual streets.Results—Of 241 children, 83 (34%) had been cut at least once while walking outdoors. Of the 83, 62 were not wearing footwear at the time of injury. The majority of lacerations (86%) were caused by broken glass. Thirty nine of the 83 children received professional medical care for the laceration. Broken glass was estimated to be present on 30% of the outdoor walking area.Conclusions—Broken glass is a significant health problem on littered urban streets. Preventive measures such as street cleaning, footwear education, and glass recycling incentives are needed to address this public health hazard.
An observational study of protective equipment use among in-line skaters: Table 1
Authors: Warda Lynne , Harlos Sande , Klassen Terry P , Moffatt Michael E K , Buchan Norma , Koop Virginia L 
Published: December 2008

Objectives—To describe the patterns of protective equipment use by in-line skaters in Winnipeg, Manitoba and nearby rural communities.Methods—In-line skaters were observed for three months in 1996 at 190 urban and 30 rural sites selected using a formal sampling scheme. Age, gender, protective equipment use, skating companions, correct helmet use, and use of headphones were recorded.Results—Altogether 123 in-line skaters were observed at 61 sites, including one rural site. No skaters were observed at the remaining sites. There were 37 adults and 86 children; 56% were male. Helmet use was 12.2% (95% confidence interval (CI ) = 6.4% to 18.0%), wrist guard use was 16.3% (95% CI = 9.7% to 22.8%), knee pad use was 9.8% (95% CI = 5.2% to 16.4%), and elbow pad use was 7.3% (95% CI = 3.4% to 13.4%). Children were more likely to wear a helmet than teens 12–19 years of age (relative risk (RR) = 30, 95% CI = 4.01 to 225). Adults were more likely to wear wrist guards than children (RR = 4.32, 95% CI = 1.87 to 9.94). No gender differences were found. Incorrect helmet use was documented in four skaters; three skaters were wearing headphones.Conclusions—Low rates of protective equipment use were documented in our region, significantly lower than those reported in the literature. Barriers to equipment use are not known, and should be examined by further study. In-line skating safety programs should be developed, promoted, and evaluated. Teens should be targeted for future preventive efforts.
Are life vests worn? A multiregional observational study of personal flotation device use in small boats: Table 1
Authors: Quan Linda , Bennett Elizabeth , Cummings Peter , Trusty Michaela N , Treser Charles D 
Published: December 2008

Objective—Although life vest use is thought to prevent drowning, their use by boaters has not been described. This study sought to determine the use of personal flotation devices (PFDs) in small boats.Methods—Boaters were observed between April and June 1995 in Washington and Oregon and classified by their age, gender, PFD use, and boat type.Results—Among 4181 boaters, 25% wore a PFD. Use was highest in <5 year olds (91%) and lowest in those over 14 years (13%). Those in kayaks were most likely (78%) and those in motor boats (19%) were least likely to wear a PFD. Females were more likely to wear a PFD than males (relative prevalence 1.5, 95% confidence interval 1.3 to 1.6). When a child less than 15 years was in a boat with an adult, PFD use was 65% if no adult wore a PFD and 95% if at least one accompanying adult wore a PFD (p=0.001).Conclusions—Generally, PFD use by boaters was low in the Northwestern US. Efforts to increase PFD use should target adolescents, adults and specific boating populations, especially those in motor boats.
Some observations on waterslide injuries: Figure 1
Authors: Ball David J 
Published: December 2008

Study objective—To investigate the causes of a series of interperson collisions on a waterslide resulting in serious injury, and to assess adequacy of control systems and legal liability.Method—Site investigation of operating characteristics including a traffic light controlled system, organisational safety culture, and user behaviour.Results—Despite a battery of safety features including closed circuit TV, citizen's band radios, a traffic light controlled system, part time supervision, and warning notices, the system was found to be inherently “unsafe” as operated. It placed a small but significant percentage of users in a hazardous situation whereby consecutive riders could collide with each other while in the flumeeven when conforming with all instructions. The realised risk might have been even higher were not staff and users adopting their own precautionary measures.Conclusions—The risk to waterslide users, even the majority observing the safety rules, was questionably high, and facility operators were vulnerable to a court ruling that they had failed in their duty of care. It is suggested that waterslide operators elsewhere, who are wholly or partially reliant on traffic light controlled systems, should carefully scrutinise the safety of their operating systems. Members of the public who use these facilities would, in any event, be well advised to remain vigilant whatever the perceived adequacy of the safety system in operation.
Injuries associated with fireworks in Victoria: an epidemiological overview: Table 1
Authors: Abdulwadud Omar , Ozanne-Smith Joan 
Published: December 2008

Objectives—To determine the epidemiological features of injuries associated with fireworks.Design—A retrospective study of reported cases.Subjects—Subjects were those who attended selected Victorian hospital emergency departments (n=17) and those admitted for firework related injuries (n=16).Results—The mean (SD) age of attenders at emergency department between January 1988 and June 1996, was 8.9 (6.2) years and most (88%) were under 18 years of age. Males accounted for 71% of the cases. The most common anatomical sites and types of injury were head (47%) and burns (88%), respectively. About 53% of the injuries were caused by firecrackers, the remainder by sparklers and penny bangers. Among those admitted to hospital between July 1987 and June 1996, the mean (SD) age was 22.9 (14.8) years and 50% were under 18 years of age. Males accounted for 87% of the cases. There was a significant difference in mean age between those admitted and not admitted to hospital, the former being significantly older.Conclusions—Although relatively rare, injuries from fireworks still occur in Victoria after legislative restrictions on their sale in 1985. Consequently, there is a potential risk for injuries among children, particularly from firecrackers. More enforcement of the regulations, education, and parental supervision are needed to prevent injuries from fireworks.
Young driver involvement in fatal motor vehicle crashes and trends in risk behaviors, United States, 1988–95
Authors: Phebo Luciana , Dellinger Ann M 
Published: December 2008

Objective—To review trends and risk factors in fatal motor vehicle crashes (MVCs) for drivers aged 15–20 years.Methods—Fatality Analysis Reporting System data from 1988 to 1995 were used. Drivers were divided into three age strata: 15–17 years, 18–20 years, and ≥21 years. Comparisons were made based on rates of driver involvement in fatal MVCs, the percentage of drivers involved in night time fatal MVCs, fatal MVCs without the use of restraints, and fatal MVCs with positive blood alcohol concentration.Results—Over the eight years, the rate of driver involvement in fatal MVCs for those 15–17 dropped 15.5%; for those 18–20 years it dropped 22.0%, and for those ≥21 years it declined 13.5%. When combining both age groups results were similar. In 1988, 60.4% of young drivers involved in fatal MVCs were not using restraints, but by 1995 the percentage dropped to 46.0%. Night time fatal crashes, the second most frequent risk behavior, declined from 41.7% in 1988 to 35.2% in 1995. Alcohol related traffic fatalities were responsible for 32.1% of fatal MVCs among young drivers in 1988 and for 20.3% in 1995.Conclusion—To accelerate these trends, implementation and evaluation of complete graduated driver licensing systems (GDLSs) is recommended. Under GDLSs, young drivers are subject to zero alcohol tolerance, curfews, and passenger restraint requirements.
Parental decisions to use infant walkers
Authors: Bar-on Miriam E , Boyle Russell M , Endriss E Kay 
Published: December 2008

Objective—To assess parental decision making in the acquisition of an infant walker and the influences surrounding that decision.Design/methods—Caretakers of children attending a residents' continuity practice during a one month period were invited to participate in a structured interview to assess various aspects of infant safety. Ten questions specifically addressed infant walkers and the decision to acquire one; seven questions collected demographic data.Results—One hundred and fifty four primary caretakers participated. Of these, 77% (n=119) of caretakers used infant walkers for their child. For children who were not first born, 85% of caretakers had used walkers with their other children. No statistically significant differences were found between walker users and non-users with respect to the sex or birth order of the child, race, education, or (type of) caretaker. Also, no differences were found between these groups with respect to having received safety information from the pediatrician. For users, 97% heard about walkers before their baby's birth, but 65% did not decide to use one until after the birth. In addition, 61% of walker users stated that no one influenced their decision to get a walker and 75% bought their own. These decisions were not affected by caretaker education or birth order of the child. Finally, 78% believed that walkers were beneficial, and 72% believed that walker use accelerated development of independent walking skills.Conclusions—Mothers purchased walkers because of no uniformed perception of benefit. A period of time, up to several months in length, exists from when the first mother hears about walkers until she decides to purchase one. Until legislation can be passed banning walkers, this period of time may provide a window of opportunity for appropriate anticipatory guidance in the form of intense media assisted, antiwalker campaigns.
Pediatric practice based evaluation of the Steps to Prevent Firearm Injury program
Authors: Oatis Pamela J , Buderer Nancy M Fenn , Cummings Peter , Fleitz Rosemarie 
Published: December 2008

Objective—To estimate the prevalence of gun ownership and methods of gun storage in homes of pediatric patients before and after an educational intervention.Design—Before and after trial.Setting—Hospital based, inner city, pediatric primary care practice.Participants—Consecutive sample of parents of patients with appointments August to November 1994.Intervention—Before the intervention, participants completed an anonymous questionnaire regarding ownership and storage of guns in their home. The intervention followed the Steps to Prevent Firearm Injury program of the American Academy of Pediatrics. It began after the parent completed the questionnaire and was reinforced at subsequent visits until July 1995. Families completing a baseline questionnaire and returning to the office July to October 1995 were resurveyed.Main outcome measure—Reported change in gun ownership and methods of storage.Results—A gun(s) in the home was reported by 8.7% of respondents. Matched baseline and follow up questionnaires were available for 23.6% of families. In these, gun ownership reportedly decreased after intervention from 9.4% to 7.0%, handgun ownership fell from 5.4% to 3.0%, and long gun ownership fell from 6.1% to 5.5%. Storing guns outside of a locked container did not change from the baseline prevalence of 2.7%, but keeping any gun loaded fell from 1.6% to 0.5%. All p values were >0.05.Conclusion—This study was unable to demonstrate a statistically significant decline in gun ownership or improvement in gun storage after a practice based intervention designed to encourage these behaviors.
Evaluating the impact of a street barrier on urban crime
Authors: Zavoski Robert W , Lapidus Garry D , Lerer Trudy J , Burke Georgine , Banco Leonard I 
Published: December 2008

Objectives—Violence is a major urban public health problem in the United States. The impact of a physical barrier placed across a street in a public housing project to prevent street violence and drug activity was evaluated.Methods—Hartford Police Department data on violent and drug related crime incidence within the housing project containing the barrier were analyzed by use of a computerized geographic information system.Results—Violent crime decreased 33% on the intervention street during the 15 month period after erection of the barrier, compared with the 15 month period before erection of the barrier, but there was no change in drug related crime. On adjoining streets and surrounding blocks, violent crime decreased 30%–50% but drug related crimes roughly doubled. A non-adjacent area of the housing project and the entire city experienced 26% and 15% decreases in violent crimes, and 414% and 25% increases in drug crimes, respectively.Conclusions—The barrier decreased violent crime but displaced drug crimes to surrounding areas of the housing project. These results have important implications for other cities that have erected or are considering erecting similar barriers.
Risk of upper limb injury in left handed children: a study in Greece
Authors: Skalkidou Alkistis , Petridou Eleni , Dessypris Nick , Karanikas Elias , Pistevos George , Trichopoulos Dimitrios 
Published: December 2008

Objectives—To investigate whether left handed children are at increased risk for injuries, particularly upper limb injuries.Setting—Athens, Greece, during a six month period in 1995–96.Methods—Cases were 129 children 4–14 years old with unintentional upper limb injuries from a population based injury database. Two control children matched for gender and age were selected from among those seen at the same medical institution for minor, non-injury ailments. On the basis of information provided by the children and their guardians, sociodemographic variables were recorded, hand preference was assessed, and each child's activity score was calculated through an abbreviated version of Achenbach's scale.Results—Left handed children have a moderately increased upper limb injury risk with a tendency of recurrence of this injury. The risk of upper limb injury is also raised among children of young fathers, whereas it appears to be inversely related to crowding index and activity score—three variables that were controlled for as potential confounders.Conclusions—This study provides limited support for the hypothesis that left handed children are at increased risk for injury. The excess risk, if genuine, is likely to be limited to cultural settings in which right handedness is perceived as the norm.
An intervention to reduce playground equipment hazards
Authors: Roseveare Christine A , Brown Judith M , McIntosh Jillian M Barclay , Chalmers David J 
Published: December 2008

Objectives—A community intervention trial was carried out to evaluate the relative effectiveness of two methods of reducing playground hazards in schools. The study hypotheses were: (1) a health promotion programme addressing barriers to implementing the New Zealand Playground Safety Standard will reduce playground hazards and (2) the intervention programme will be more successful than providing information alone.Methods—Twenty four schools in Wellington, New Zealand were randomly allocated into two groups of 12 and their playgrounds audited for hazards. After the audit, the intervention group received a health promotion programme consisting of information about the hazards, an engineer's report, regular contact and encouragement to act on the report, and assistance in obtaining funding. The control group only received information about hazards in their playground.Results—After 19 months, there was a significant fall in hazards in the intervention schools compared with the control schools (Mann-Whitney U test, p=0.027). No intervention schools had increased hazards and eight out of 12 had reduced them by at least three. In contrast, only two of the control schools had reduced their hazards by this amount, with three others increasing their hazards in that time.Conclusions—It is concluded that working intensively with schools to overcome barriers to upgrading playground equipment can lead to a reduction in hazards, and that this form of intensive intervention is more effective than providing information alone.
Validity of self reported crashes and injuries in a longitudinal study of young adults
Authors: Begg Dorothy J , Langley John D , Williams Sheila M 
Published: December 2008

Objectives—The aim of this study was to determine the validity of self report as a source of information on crashes and injuries.Setting—This study was part of the Dunedin Multidisciplinary Health and Development Study (DMHDS), which is a longitudinal study of the health, development, and behaviour of a cohort of young New Zealanders.Method—At the age 21 assessment DMHDS study members were asked to report serious injury and motor vehicle traffic crashes experienced over the previous three years. The self reported injuries were compared with the New Zealand Health Information Service (NZHIS) public hospital discharge file to determine the completeness of the self reported data. The traffic crashes were compared with the police traffic crash reports to determine the accuracy of self reported crash details.Results—Twenty five (86%) of the 29 unintentional injuries, six (67%) of the nine assaults, and one (14%) of the six self inflicted injuries on the NZHIS file were self reported. The level of agreement between the self reported crash details and those recorded on the traffic crash report was high.Conclusions—The results show that self reports can be a useful and valid source of injury and crash data.