title: Preventing child pedestrian injuries and deaths arising from vehicle-child accidents in domestic driveways: An action research project

authors: Cowley, Natalie Anne

subjects: child safety

abstract: This research was a three-fold investigation into the viability of previous recommendations for vehicle-related child driveway accident safety . Firstly, the groups most at risk of these types of accidents were determined in order that they could be specifically considered when reviewing the practicalities of previous recommendations . Secondly, the feasibility of previous recommendations was systematically examined through both an extensive literature review and key and expert informant interviews . Based on these, the likelihood of implementation of previous safety recommendations for the identified high risk groups was ascertained, providing a basis on which to abandon some previous recommendations, remove obstacles to others which would enhance practicability and generate further recommendations that would be tenable for the at-risk groups in particular.

The key findings of this research were, foremost, that there is a noticeable lack of specific reference to vehicle-related child driveway accidents in any legislation or safety guidelines, as well as a shortage of official data that deal expressly with this type of accident. Further, it was found that the major obstacles to the implementation of previous recommendations - particularly the environmental ones - were cost, autonomy, and spatial constraints. While several recommendations were abandoned due to factors such as unproven or dubious effectiveness and/or prohibitive cost, it was found that the most viable recommendations were characterised by their relatively low cost for the families involved. These recommendations were typically environmental or educational in nature.

Thus, the recommendations in this report include some moderate regulatory changes to facilitate greater uptake of environmental and behaviour-modifying recommendations as well as practical ideas that all need to be part of a cohesive campaign to address the issue of vehicle-related child driveway accidents in New Zealand.

text: Preventing child pedestrian injuries and deaths arising from vehicle-child accidents in domestic driveways: An action research project This research was a three-fold investigation into the viability of previous recommendations for vehicle-related child driveway accident safety . Firstly, the groups most at risk of these types of accidents were determined in order that they could be specifically considered when reviewing the practicalities of previous recommendations . Secondly, the feasibility of previous recommendations was systematically examined through both an extensive literature review and key and expert informant interviews . Based on these, the likelihood of implementation of previous safety recommendations for the identified high risk groups was ascertained, providing a basis on which to abandon some previous recommendations, remove obstacles to others which would enhance practicability and generate further recommendations that would be tenable for the at-risk groups in particular.

The key findings of this research were, foremost, that there is a noticeable lack of specific reference to vehicle-related child driveway accidents in any legislation or safety guidelines, as well as a shortage of official data that deal expressly with this type of accident. Further, it was found that the major obstacles to the implementation of previous recommendations - particularly the environmental ones - were cost, autonomy, and spatial constraints. While several recommendations were abandoned due to factors such as unproven or dubious effectiveness and/or prohibitive cost, it was found that the most viable recommendations were characterised by their relatively low cost for the families involved. These recommendations were typically environmental or educational in nature.

Thus, the recommendations in this report include some moderate regulatory changes to facilitate greater uptake of environmental and behaviour-modifying recommendations as well as practical ideas that all need to be part of a cohesive campaign to address the issue of vehicle-related child driveway accidents in New Zealand.

year: 2005

title: Honey: Antimicrobial actions and role in disease management

authors: Molan, Peter C.

subjects: honey

abstract: The ancient treatment of dressing infected wounds with honey is rapidly becoming re-established in professional medicine, especially where wounds are infected with antibiotic-resistant bacteria. This is because of the demonstrated sensitivity of such bacteria to the antibacterial activity of honey, which is not influenced by whether or not strains are resistant to antibiotics. Honey has been found to have a very broad spectrum of activity, but its potency of antibacterial activity can vary greatly. In most honeys the antibacterial activity is due to enzymatically produced hydrogen peroxide and thus the potency of its antibacterial activity can be decreased by catalase present in an open wound. Manuka honey has an antibacterial component derived from the plant source. Manuka honey with a quality-assured level of antibacterial activity is being used by companies marketing honey products for wound care that are registered with the medical regulatory authorities in various countries. Such honey can be diluted IO-fold or more and still completely inhibit the usual wound-infecting species. There is a large amount of clinical evidence for the effectiveness of honey in clearing infection in wounds, and some clinical evidence of its effectiveness in treating other infections. Although the antibacterial potency of honey is insufficient to allow its use systemically, there are various clinical applications besides wound care in which it is used topically or where it does not get excessively diluted, such as for treatment of gastritis, enteritis, gingivitis, ophthalmological infections and bronchial infections. In most of these applications the anti-inflammatory activity of honey is of additional benefit in decreasing the inflammation resulting from infection. Additional clinical research is needed to provide better evidence of the effectiveness of honey in these therapeutic applications of honey.

text: Honey: Antimicrobial actions and role in disease management The ancient treatment of dressing infected wounds with honey is rapidly becoming re-established in professional medicine, especially where wounds are infected with antibiotic-resistant bacteria. This is because of the demonstrated sensitivity of such bacteria to the antibacterial activity of honey, which is not influenced by whether or not strains are resistant to antibiotics. Honey has been found to have a very broad spectrum of activity, but its potency of antibacterial activity can vary greatly. In most honeys the antibacterial activity is due to enzymatically produced hydrogen peroxide and thus the potency of its antibacterial activity can be decreased by catalase present in an open wound. Manuka honey has an antibacterial component derived from the plant source. Manuka honey with a quality-assured level of antibacterial activity is being used by companies marketing honey products for wound care that are registered with the medical regulatory authorities in various countries. Such honey can be diluted IO-fold or more and still completely inhibit the usual wound-infecting species. There is a large amount of clinical evidence for the effectiveness of honey in clearing infection in wounds, and some clinical evidence of its effectiveness in treating other infections. Although the antibacterial potency of honey is insufficient to allow its use systemically, there are various clinical applications besides wound care in which it is used topically or where it does not get excessively diluted, such as for treatment of gastritis, enteritis, gingivitis, ophthalmological infections and bronchial infections. In most of these applications the anti-inflammatory activity of honey is of additional benefit in decreasing the inflammation resulting from infection. Additional clinical research is needed to provide better evidence of the effectiveness of honey in these therapeutic applications of honey.

year: 2009

title: Management of patients with early stage lung cancer - why do some patients not receive treatment with curative intent?

authors: Lawrenson, Ross

subjects: Lung cancer

abstract: BACKGROUNDS: This study aims to understand the factors that influence whether patients receive potentially curative treatment for early stage lung cancer. A key question was whether indigenous Māori patients were less likely to receive treatment. 
METHODS: Patients included those diagnosed with early stage lung cancer in 2011-2018 and resident in the New Zealand Midland Cancer Network region. Logistic regression model was used to estimate the odds ratios of having curative surgery/ treatment. The Kaplan Meier method was used to examine the all-cause survival and Cox proportional hazard model was used to estimate the hazard ratio of death. 
RESULTS: In total 419/583 (71.9%) of patients with Stage I and II disease were treated with curative intent - 272 (46.7%) patients had curative surgery. Patients not receiving potentially curative treatment were older, were less likely to have non-small cell lung cancer (NSCLC), had poorer lung function and were more likely to have an ECOG performance status of 2+. Current smokers were less likely to be treated with surgery and more likely to receive treatment with radiotherapy and chemotherapy. Those who were treated with surgery had a 2-year survival of 87.8% (95% CI: 83.8-91.8%) and 5-year survival of 69.6% (95% CI: 63.2-76.0%). Stereotactic ablative body radiotherapy (SABR) has equivalent effect on survival compared to curative surgery (hazard ratio: 0.77, 95% CI: 0.37-1.61). After adjustment we could find no difference in treatment and survival between Māori and non-Māori. 
CONCLUSIONS: The majority of patients with stage I and II lung cancer are managed with potentially curative treatment - mainly surgery and increasingly with SABR. The outcomes of those being diagnosed with stage I and II disease and receiving treatment is positive with 70% surviving 5 years.

text: Management of patients with early stage lung cancer - why do some patients not receive treatment with curative intent? BACKGROUNDS: This study aims to understand the factors that influence whether patients receive potentially curative treatment for early stage lung cancer. A key question was whether indigenous Māori patients were less likely to receive treatment. 
METHODS: Patients included those diagnosed with early stage lung cancer in 2011-2018 and resident in the New Zealand Midland Cancer Network region. Logistic regression model was used to estimate the odds ratios of having curative surgery/ treatment. The Kaplan Meier method was used to examine the all-cause survival and Cox proportional hazard model was used to estimate the hazard ratio of death. 
RESULTS: In total 419/583 (71.9%) of patients with Stage I and II disease were treated with curative intent - 272 (46.7%) patients had curative surgery. Patients not receiving potentially curative treatment were older, were less likely to have non-small cell lung cancer (NSCLC), had poorer lung function and were more likely to have an ECOG performance status of 2+. Current smokers were less likely to be treated with surgery and more likely to receive treatment with radiotherapy and chemotherapy. Those who were treated with surgery had a 2-year survival of 87.8% (95% CI: 83.8-91.8%) and 5-year survival of 69.6% (95% CI: 63.2-76.0%). Stereotactic ablative body radiotherapy (SABR) has equivalent effect on survival compared to curative surgery (hazard ratio: 0.77, 95% CI: 0.37-1.61). After adjustment we could find no difference in treatment and survival between Māori and non-Māori. 
CONCLUSIONS: The majority of patients with stage I and II lung cancer are managed with potentially curative treatment - mainly surgery and increasingly with SABR. The outcomes of those being diagnosed with stage I and II disease and receiving treatment is positive with 70% surviving 5 years.

year: 2020