Showing papers in "Injury Prevention in 2010"
TL;DR: The health outcomes due to intimate partner and sexual violence are comparable to (and in some cases exceed) those associated with many other better-known health risk factors.
Abstract: Intimate partner and sexual violence affect a large proportion of the population. The majority of those directly experiencing such violence are women, and the majority perpetrating it are men. The WHO Multi-Country Study on Women's Health and Domestic Violence against Women,1 for instance, indicated that 15-71% of women experience physical and/or sexual violence by an intimate partner at some point in their lives. The majority of those directly experiencing such violence are women, and the majority perpetrating it are men.
The harm these forms of violence cause can last a lifetime and span generations. They have serious adverse effects on health, education, employment and the wider economy. The health outcomes due to intimate partner and sexual violence are comparable to (and in some cases exceed) those associated with many other better-known health risk factors. For example, a study in Victoria, Australia, estimated that among women 18–44 years of age, intimate partner violence was associated with 7% of the overall burden of disease and was a larger risk factor than raised blood pressure, tobacco use and increased body weight.2 Intimate partner violence also very often has severe negative impacts on the emotional and social well-being of entire families, affecting parenting skills …
701 citations
TL;DR: Children 0–4 years, adolescents 15–19 years, and adults>65 years were most likely to sustain a TBI and adults >75 years had the highest rate for hospitalisation and death, and motor vehicle traffic was the leading cause of TBI death.
Abstract: Introduction Traumatic Brain Injury (TBI) is an important public health problem in the United States (US) resulting in disabling conditions and long-term societal costs. Thus, there a compelling need for prevention, treatment and rehabilitation initiatives informed by national, population-based data. Objective To estimate the prevalence and incidence of TBI in the US utilizing several nationally representative data sets. Methods To produce national estimates, we averaged and analysed data from 2002–2006 for TBI-related visits to hospital-based emergency departments (EDs), hospitalisations, and deaths from the National Hospital Ambulatory Medical Care Survey, the National Hospital Discharge Survey, and the National Vital Statistics System, respectively. Results For 2002–2006, the estimated average annual incidence of TBI was 1.7 million, including 52 000 deaths, 275 000 hospitalisations, and 1 365 000 ED visits. For all age groups, the leading external causes were as follows: falls (35.2%); motor vehicle traffic (17.3%); struck by/against events (16.5%); assaults (10%). Rates were higher for males than females in all age groups. Falls produced the greatest number of TBI-related ED visits, (523 043) and hospitalizations (62 334). Motor vehicle traffic was the leading cause of TBI death, with rates highest among those 20–24 years. Children 0–4 years, adolescents 15–19 years, and adults >65 years were most likely to sustain a TBI and adults >75 years had the highest rate for hospitalisation and death. Annually, almost half a million TBI-related ED visits, 473 947, were made by children aged 0–4 years. TBI was a contributing factor to one third of all injury related deaths in the US.
216 citations
TL;DR: Reducing access to firearms for DVRO defendants, increasing police staffing levels and allowing the warrantless arrest of DVROs violators may reduce the city-level risk of IPH.
Abstract: Objective To assess the relationships between intimate partner homicide (IPH) and public policies including police staffing levels in large US cities. Design The research uses a multiple time-series design to examine the effects of statutes aimed at restricting access to firearms for perpetrators of domestic violence, allowing or mandating arrest for violators of domestic violence restraining orders (DVROs), beer excise taxes, and police staffing levels on IPH in 46 of the largest US cities from 1979 to 2003. Both total IPH and IPH committed with a firearm are analysed. Generalised estimating equations using a Poisson distribution are used to regress IPH on the policies and potential confounders. Results State statutes restricting those under DVROs from accessing firearms, and laws allowing the warrantless arrest of DVRO violators, are associated with reductions in total and firearm IPH. Police staffing levels are also negatively associated with total and firearm IPH. There was no evidence that other policies to restrict firearm access to domestic violence offenders or alcohol taxes had a significant impact on IPH. Conclusions Reducing access to firearms for DVRO defendants, increasing police staffing levels and allowing the warrantless arrest of DVRO violators may reduce the city-level risk of IPH. Future research should evaluate factors that may mediate the effects of these laws and increased police staffing levels on IPH to determine whether there are opportunities to increase their protective effects. Further research is needed on firearm law implementation to determine why the other tested laws were not found effective.
114 citations
TL;DR: Addressing job strain could provide significant benefit for those with neck and wrist/hand pain, while the effects of somatisation and the promotion of good mental health may provide smaller but global benefits.
Abstract: Objective To investigate the association of physical and psychosocial risk factors with musculoskeletal disorders (MSDs) in New Zealand nurses, postal workers and office workers. Design A cross-sectional postal survey asking about demographic, physical and psychosocial factors and MSDs. Participants A total of 911 participants was randomly selected; nurses from the Nursing Council of New Zealand database (n=280), postal workers from their employer9s database (n=280) and office workers from the 2005 electoral roll (n=351). Outcome Measures Self-reported pain in the low back, neck, shoulder, elbow, wrist/hand or knee lasting more than 1 day in the month before the survey. Results The response rate was 58%, 443 from 770 potential participants. 70% (n=310) reported at least one MSDs. Physical work tasks were associated with low back (odds ratio (OR) 1.35, 95% CI 1.14 to 1.6), shoulder (OR 1.41, 95% CI 1.17 to 1.69), elbow (OR 1.14, 95% CI 1.13 to 1.83) and wrist/hand pain (OR 1.39, 95% CI 1.15 to 1.69). Job strain had the strongest association with neck pain (OR 3.46, 95% CI 1.30 to 9.21) and wrist/hand pain. Somatisation was weakly associated with MSDs at most sites. Better general and mental health status were weakly associated with lower odds of MSDs. Conclusions In injury prevention and rehabilitation the physical nature of the work needs to be addressed for most MSDs, with modest decreases in risk seemingly possible. Addressing job strain could provide significant benefit for those with neck and wrist/hand pain, while the effects of somatisation and the promotion of good mental health may provide smaller but global benefits.
113 citations
TL;DR: Body checking was found to be associated with an increased risk of injury and policy implications regarding delaying body checking to older age groups and to only the most elite levels requires further rigorous investigation.
Abstract: Objective To identify risk factors for injury in youth ice hockey (ie, body checking, age, player position, player experience and level of play). Study design Systematic review and meta-analysis. Methods A systematic review of the literature, including a meta-analysis component was completed. Ten electronic databases and the American Society for Testing and Materials Safety in Ice Hockey series (volumes 1–4) were systematically searched with strict inclusion and exclusion criteria to identify articles examining risk factors for injury in youth ice hockey. Results Participation in games, compared with practices, was associated with an increased risk of injury in all studies examined. Age, level of play and player position produced inconsistent findings. Body checking was identified as a significant risk factor for all injuries (summary rate ratio: 2.45; 95% CI 1.7 to 3.6) and concussion (summary odds ratio: 1.71; 95% CI 1.2 to 2.44). Conclusions Findings regarding most risk factors for injury remain inconclusive; however, body checking was found to be associated with an increased risk of injury. Policy implications regarding delaying body checking to older age groups and to only the most elite levels requires further rigorous investigation.
109 citations
TL;DR: The DRIVE study as mentioned in this paper found that there was a high level of accuracy in young drivers' self-report of police recorded crashes (85.1%; 95% CI 78.2% to 92.1%) and of traffic offences (83.0% to 86.6%).
Abstract: In order to determine the accuracy of self-report of on-road crashes and traffic offences among participants in the DRIVE study, 2991 young drivers in New South Wales, Australia who completed the follow-up questionnaire were asked whether they had been involved in an on-road crash or were convicted for a traffic offence while driving during the year prior to the survey. This information was linked to police crash data to determine the level of accuracy of self-report of on-road crashes. There was a high level of accuracy in young drivers' self-report of police recorded crashes (85.1%; 95% CI 78.2% to 92.1%) and of police recorded traffic offences (83.0%; 95% CI 79.4% to 86.6%). Results suggest that surveys may be useful tools for estimating the incidence of on-road crashes and traffic offences in young drivers. The findings are particularly relevant to jurisdictions where access to administrative data is limited.
73 citations
TL;DR: A longitudinal analysis of mortality and morbidity data on injuries in the elderly, examining variations in recent trends by cause, sex, race/ethnicity and age group, found the reported rate of fatal falls for people aged 65 years and over increased by 42% during 2000–6 but non-fatal falls did not increase.
Abstract: Objective To identify recent increases in mortality and morbidity rates from injuries among Americans aged 65 years and over. Design A longitudinal analysis of mortality and morbidity data on injuries in the elderly, examining variations in recent trends by cause, sex, race/ethnicity and age group. Setting USA, mortality rate (2000–6) and morbidity rate (2001–7). Data sources Centers for Disease Control and Prevention9s web-based injury statistics query and reporting system online database. Main outcome measures Linear regression was used to examine the statistical significance of trends in mortality and morbidity rates in the study period. The percentage change in rates was used to measure the linear trend. Race/ethnicity was classified into Hispanic (all races except black), non-Hispanic white (‘white’) and black. Results Injury mortality for people aged 65 years and over increased by 3% during 2000–6; morbidity increased by 7% during 2001–7. Falls mortality increased by 42% but emergency department visits for falls did not increase. Significant increases in death rates occurred in motorcycle crashes (145%), machinery (46%), poisoning (34%) and drowning (19%); morbidity rates increased in poisoning (143%), motorcycle crashes (86%), machinery (48%), bicycles (24%), struck by/against (13%) and overexertion (11%). Motor vehicle occupant injuries decreased. Conclusions The reported rate of fatal falls for people aged 65 years and over increased by 42% during 2000–6 but non-fatal falls did not increase. Research is needed to explain the inconsistent changes between fatal and non-fatal falls, and to identify risk factors contributing to the significant increases in both fatal and non-fatal injuries from machinery, motorcycle crashes and unintentional poisoning.
73 citations
TL;DR: Overall characteristics of both the family and child predicted a TBI event, and evidence of modest increases in the rate of TBI for those in the highest risk categories compared to the lowest risk categories is suggested.
Abstract: Background and Objective Traumatic brain injury (TBI) is a frequently occurring event in childhood that may have significant ongoing effects. Little is known about the child and family characteristics that predispose children to these injuries. A greater understanding of the risk factors associated with childhood TBI may provide an opportunity to prevent their occurrence. Methods Information provided by a large birth cohort study (n¼1265) was used to determine the child and family risk factors of TBI in children aged 0e15 years (n¼187). All information regarding child, family, and injury events were collected prospectively and unrelated to the injury event itself. Child variables included in the analysis were sex and the level of behavioural problems. Parental variables included were family socioeconomic status, mother’s age, education level, depressive symptoms, number of adverse life events experienced by the family, and parenting style. Results The most important risk factors were sex, adverse life events, and parenting style. The results suggest evidence of modest increases in the rate of TBI for those in the highest risk categories (male, $4 life events per annum, high maternal punitiveness) compared to the lowest risk categories, with hazard ratios in the region of 1.4e1.6. Conclusions Overall characteristics of both the family and child predicted a TBI event. An increased understanding of risks associated with TBI in childhood will provide an avenue to prevent these injuries by targeting at-risk families and aiding the development of appropriate intervention strategies.
72 citations
TL;DR: As it is difficult to ban the use of electric bicycles in China, laws, rules and regulations need to be reinforced and strengthened to ensure the safety of electric bicycle riders and others on the road.
Abstract: Objective To examine the rising casualty rate related to electric bicycle usage. Design Analysis of the Hangzhou Police Bureau9s data on electric-bicycle-related injuries and deaths. Setting Hangzhou, China, 2004–2008. Patients or subjects Electric-bicycle riders. Main outcome measure Electric-bicycle-related casualty rates in Hangzhou from 2004 to 2008. Results There was a significant average annual increase in electric-bicycle-related casualty rates of 2.7 per 100 000 population (95% CI 1.5 to 3.9, p=0.005). At the same time, overall road traffic and manual-bicycle-related deaths and injuries decreased. Conclusion As it is difficult to ban the use of electric bicycles in China, laws, rules and regulations need to be reinforced and strengthened. New regulations should be created for the safety of electric bicycle riders and others on the road, and mandatory helmet use should be considered.
71 citations
TL;DR: This study compares skiing and snowboarding injuries in terrain parks versus slopes at two ski areas, 2000–05, and finds that terrain park injuries were more likely to be severe, involving head or back injuries.
Abstract: This study compares skiing and snowboarding injuries in terrain parks versus slopes at two ski areas, 2000–05. A total of 3953 (26.7%) injuries occurred in terrain parks, predominantly among young male snowboarders. Terrain park injuries were more likely to be severe, involving head (RR 1.31, 95% CI 1.16 to 1.48) or back (RR 1.96, 95% CI 1.67 to 2.29).
70 citations
TL;DR: Canadian youth and adults are significantly more likely to wear helmets as the comprehensiveness of helmet legislation increases, and helmet legislation is not associated with changes in ridership.
Abstract: Background Bicycle helmet legislation has been variably implemented in six of 10 Canadian provinces. The objectives of this study were to determine the association between the comprehensiveness of helmet legislation and both helmet use and bicycle ridership. Methods Analysis of helmet use was based on data from the 2005 Canadian Community Health Survey (CCHS) and included respondents from three Canadian provinces (Saskatchewan, Ontario, and Nova Scotia). Analysis of bicycle use was based on data from the 2000–01, 2003, 2005, and 2007 cycles of the CCHS and included respondents from all provinces. In the time between the 2000–01 and 2007 cycles, two provinces (Prince Edward Island (PEI) and Alberta) implemented helmet legislation. Results Helmets were reportedly worn by 73.2% (95% CI 69.3% to 77.0%) of respondents in Nova Scotia, where legislation applies to all ages, by 40.6% (95% CI 39.2% to 42.0%) of respondents in Ontario, where legislation applies to those less than 18 years of age, and by 26.9% (95% CI 23.9% to 29.9%) of respondents in Saskatchewan, where no legislation exists. Though legislation applied to youth in both Ontario and Nova Scotia, helmet use was lower among youth in Ontario than among youth in Nova Scotia (46.7% (95% CI 44.1% to 49.4%) vs 77.5% (95% CI 70.9% to 84.1%)). Following the implementation of legislation in PEI and Alberta, recreational and commuting bicycle use remained unchanged among youth and adults. Conclusions Canadian youth and adults are significantly more likely to wear helmets as the comprehensiveness of helmet legislation increases. Helmet legislation is not associated with changes in ridership.
TL;DR: The findings indicate that the implementation of BID can reduce the incidence of violent crimes likely to result in injury to individuals and highlight the importance of targeting BID efforts to crime prevention interventions that reduce violence exposure associated with criminal behaviours.
Abstract: Objective To examine whether business improvement districts (BID) contributed to greater than expected declines in the incidence of violent crimes in affected neighbourhoods. Method A Bayesian hierarchical model was used to assess the changes in the incidence of violent crimes between 1994 and 2005 and the implementation of 30 BID in Los Angeles neighbourhoods. Results The implementation of BID was associated with a 12% reduction in the incidence of robbery (95% posterior probability interval � 2 to 24) and an 8% reduction in the total incidence of violent crimes (95% posterior probability interval � 5 to 21). The strength of the effect of BID on robbery crimes varied by location. Conclusion These findings indicate that the implementation of BID can reduce the incidence of violent crimes likely to result in injury to individuals. The findings also indicate that the establishment of a BID by itself is not a panacea, and highlight the importance of targeting BID efforts to crime prevention interventions that reduce violence exposure associated with criminal behaviours.
TL;DR: Economic and functional ramifications must be included in the spectrum of consequences ofRTIs to fully appreciate the extent of the burden of disease, implying that health systems should not only address the clinical consequences of RTIs, but the financial ones as well.
Abstract: Background Road traffic injuries (RTIs) are increasingly contributing to the burden of disease in sub-Saharan Africa, yet little is known about the economic consequences and disability associated with them. Objective To explore cost and disability consequences of RTIs in Nigeria. Design A population-based survey using two-stage stratified cluster sampling. Subject/setting Information on care-seeking choice, cost of treatment, ability to work, reduction in earnings, and disability were collected on 127 subjects who had suffered an RTI, of 3082 study subjects in seven Nigerian states. Outcome measures Univariate analysis was used to estimate frequency of disability, types of care sought, and trends for work lost, functional ability and cost of treatment. Unadjusted bivariate analysis was performed to explore care-seeking, cost of care, and work lost among disabled and non-disabled people. Results RTIs resulted in disability for 29.1% of subjects, while 13.5% were unable to return to work. Of the disabled people, 67.6% were unable to perform activities of daily living, 16.7% consequently lost their jobs, and 88.6% had a reduction in earnings. Private physician and hospital treatment were the most common forms of initial treatment sought, but traditional treatment was the most common second form of care sought. Average direct costs of informal and formal treatment were US$6.65 and US$35.64, respectively. Disabled people were more likely to seek formal care (p=0.003) and be unable to work (p=0.002). Conclusions Economic and functional ramifications must be included in the spectrum of consequences of RTIs to fully appreciate the extent of the burden of disease, implying that health systems should not only address the clinical consequences of RTIs, but the financial ones as well.
TL;DR: The Injury Expert Group within the Global Burden of Disease 2005 (GBD) Project aims to provide better estimates of the incidence, prevalence and duration of TBI in each of the 21 GBD regions, using a systematic literature review and country specific hospital and survey data.
Abstract: Traumatic brain injury (TBI) is a leading cause of disability in all regions of the globe. The global incidence rate of TBI is estimated at 200 per 100 000 people per year; however, this rate is uncertain and a likely underestimate. The Injury Expert Group within the Global Burden of Disease 2005 (GBD) Project aims to provide better estimates of the incidence, prevalence and duration of TBI in each of the 21 GBD regions. One of the two inputs into the estimates is a systematic literature review which was conducted using Medline and Embase databases. The search results were screened for relevance and data quality and the incidence, prevalence and duration of injury estimates were abstracted from the relevant literature. The second input was country specific hospital and survey data. Preliminary results from the literature review show that the incidence, prevalence and expected duration of disability from TBI differ between global regions. Data were scarce for 9 of the 21 global regions, all 9 encompassing developing countries. Obtaining estimates for developing countries is important as preliminary results show higher incidence rates from these regions. For example, the incidence rate of TBI in South Africa has been estimated at 1.5 to 3.5 times that of the estimated global rate. It is necessary to understand the absolute rate and variation of TBI across the globe so that more effective efforts can be made to reduce unnecessary suffering due to TBI throughout the world.
TL;DR: The efficacy of virtual reality to train child pedestrians in safe street crossing is tested through repeated unsupervised practice without risk, automated feedback on success of crossings, adjustment of traffic to match children's skill and a fun, appealing environment for training.
Abstract: Background Pedestrian injuries are among the leading causes of morbidity and mortality in middle childhood. One limitation to existing pedestrian safety interventions is that they do not provide children with repeated practice needed to develop the complex perceptual and cognitive skills required for safe street crossing. Virtual reality offers training through repeated unsupervised practice without risk, automated feedback on success of crossings, adjustment of traffic to match children9s skill and a fun, appealing environment for training. Objective To test the efficacy of virtual reality to train child pedestrians in safe street crossing. Setting Birmingham, Alabama, USA. Methods A randomised controlled trial is underway with an expected sample of four groups of 60 children aged 7–8 years (total N=240). One group receives training in an interactive, immersive virtual pedestrian environment. A second receives pedestrian safety training via widely used video and computer strategies. The third group receives what is judged to be the most efficacious treatment currently available, individualised behavioural training at streetside locations. The fourth group serves as a no-contact control group. All participants are exposed to a range of field and laboratory-based measures of pedestrian skill during baseline and post-intervention visits, as well as during a 6-month follow-up assessment. Outcome Measures Primary analyses will be conducted through linear mixed models testing change over time in the four intervention groups. Three pedestrian safety measures will serve as primary outcomes: temporal gap before initiating crossing, temporal gap remaining after crossing and attention to traffic while waiting to cross. Clinical Trial Registration This study is registered at the US government website, www.clinicaltrials.gov, under the title ‘Using virtual reality to train children in pedestrian safety’, registration number NCT00850759.
TL;DR: Drowning risk is strikingly higher than previously thought based on population-based estimates, and exposure adjusted person-time estimates for drowning were 200 times higher than road traffic fatalities.
Abstract: Objectives To estimate the rate of unintentional drowning mortality and hospitalised morbidity using population-based, population-risk and person-time denominator data and to compare the estimates obtained. To then compare exposure-based rates for drowning with road traffic death rates. Method Retrospective analysis of unintentional drowning mortality and hospitalised morbidity of New South Wales (NSW, Australia) residents 16+ years of age during 1 January to 31 December 2005. Information on population-risk and person-time risk was obtained from the 2005 NSW Population Health Survey. Analysis of road traffic death data from NSW and population and person-time risk estimates from the Survey of Vehicle Use, Household Travel Surveys and Roads and Traffic Authority Speed Surveys in 2005. Results Estimated drowning mortality and hospitalised morbidity rates for adults were higher using population-risk and person-time risk exposures compared to a population-based exposure. Population-based estimates of road traffic mortality were four times higher than drowning mortality rates. In contrast, exposure adjusted person-time estimates for drowning were 200 times higher than road traffic fatalities. Conclusions Many injury risks are underestimated when the total age-specific population is used to calculate an injury rate instead of actual population-risk or person-time exposure. This can result in the identification of misleading priorities for injury prevention. Drowning risk is strikingly higher than previously thought based on population-based estimates. This information is important for decision-making and policy development as it provides a basis for comparing the inherent risk in exposure to hazards with potential to cause injury.
TL;DR: A combination of the HUI and EQ-5D should be used in studies on injury-related disability, because the combination covers all relevant health dimensions, is applicable in all kinds of injury populations and in widely different age ranges.
Abstract: Objective Empirical head-to-head comparison of the health utility index (HUI) mark 2 and 3 and the EuroQol-5D (EQ-5D) in injury patients of all severity levels to obtain more insight into the strengths and limitations of the multi-attribute utility measures (MAUI) to estimate utility losses in injury populations. Design A self-assessment survey that included the EQ-5D, HUI2 and HUI3 to measure generic health-related quality of life. Patients Injury patients in The Netherlands 2 years after they attended the emergency department. Main Outcome Measures Shannon9s index and Shannon9s evenness index were used to assess absolute and relative informativity, both for the summary scores and by dimension. The study also analysed convergent and construct validity of the MAUI. Results Mean summary scores significantly differed between the instruments, with highest summary scores for HUI2 (0.88), followed by HUI3 (0.80) and EQ-5D (0.78). Absolute and relative informativity by dimension was highest for the HUI3 descriptive system. The HUI3 was most sensitive for ageing and comorbidity. The largest differences between the MAUI were found for pain/discomfort and anxiety/depression/emotion. The largest differences in discriminative power between EQ-5D and HUI (mark 2 and 3) were seen for skull–brain injury, internal organ injury and upper extremity fractures. Conclusions Different MAUI resulted in significantly different summary scores. The instruments and their dimensions performed differently for injury severity levels, ageing, comorbidity and injury groups. A combination of the HUI and EQ-5D should be used in studies on injury-related disability, because the combination covers all relevant health dimensions, is applicable in all kinds of injury populations and in widely different age ranges.
TL;DR: The Joinpoint regression models suggest that firearm suicide rates declined towards the end of the 1990s, and total suicide rates also declined among men aged 15–34 and 35–64 years during this period.
Abstract: Objectives To examine whether significant changes in method-specific male suicide rates occurred in the province of Quebec after stronger firearms regulations were introduced in Canada in 1991; to ascertain whether more stringent firearms regulations influence firearms and total suicide trends among men and to determine whether different results are obtained according to the statistical methods used Study design Descriptive analyses of time trends in method-specific suicide rates for men from 1981 to 2006 using Joinpoint regression models and pre–post firearms regulation analyses Setting Quebec (Canada) Patients or Subjects Men who have commited suicide aged 15–34, 35–64 and 65 years and over, based on the Quebec mortality database, 1981–2006 Interventions A national firearms control initiative enacted in 1991 Results The Joinpoint regression models suggest that firearm suicide rates declined towards the end of the 1990s Since 1996, the pace of decline was twice as great in men aged 15–34 years (annual percentage change (APC) −111%) compared with men aged 35–64 years (APC −56%) Total suicide rates also declined among men aged 15–34 and 35–64 years during this period Pre–post firearms regulation Poisson regression analyses failed to detect the specific point in time when significant changes in the trend occurred Conclusions Male firearm suicide rates declined following the introduction of restrictive firearms regulations in Canada Whether this represents a causal relationship requires further study
TL;DR: This tutorial attempts to bridge research to practice through the presentation of a practical, systematic, six-step approach that borrows from established frameworks in health promotion and disease prevention.
Abstract: Behavioural science when combined with engineering, epidemiology and other disciplines creates a full picture of the often fragmented injury puzzle and informs comprehensive solutions. To assist efforts to include behavioural science in injury prevention strategies, this paper presents a methodological tutorial that aims to introduce best practices in behavioural intervention development and testing to injury professionals new to behavioural science. This tutorial attempts to bridge research to practice through the presentation of a practical, systematic, six-step approach that borrows from established frameworks in health promotion and disease prevention. Central to the approach is the creation of a programme theory that links a theoretically grounded, empirically tested behaviour change model to intervention components and their evaluation. Serving as a compass, a programme theory allows for systematic focusing of resources on the likely most potent behavioural intervention components and directs evaluation of intervention impact and implementation. For illustration, the six-step approach is applied to the creation of a new peer-to-peer campaign, Ride Like a Friend/Drive Like You Care, to promote safe teen driver and passenger behaviours.
TL;DR: Providers in an urban emergency department (ED) responded to a confidential, online survey assessing their beliefs and practices with respect to reducing a suicidal person's access to lethal means of suicide, finding that psychiatrists were more likely than ED staff to report always asking suicidal patients about access to firearms.
Abstract: Providers in an urban emergency department (ED) responded to a confidential, online survey assessing their beliefs and practices with respect to reducing a suicidal person's access to lethal means of suicide. 26% of respondents (37% of ED nurses, 23% of ED physicians, and 9% of psychiatrists) believed that all of the jumpers from the Golden Gate Bridge would have found a lethal suicide alternative had a barrier been present, and an additional 38% thought that most would have. Two-thirds of respondents believed that providers in the ED should always ask suicidal patients about access to firearms, yet 52% (67% of nurses, 54% of ED physicians, and 13% of psychiatrists) reported rarely or never doing so. Psychiatrists were more likely than ED staff to report always asking. Further understanding these attitudes and behaviours could enhance suicide prevention activities in the ED.
TL;DR: It is concluded that Ghanaian papers provide detailed coverage of traffic injury and areas for improvement include pedestrian injury and attention to preventable risk factors such as road risk factors, seatbelt use, speed control, and alcohol use.
Abstract: In order to analyse traffic injury reporting in Ghanaian newspapers and identify opportunities for improving road safety, the content of 240 articles on road traffic injury was reviewed from 2005 to 2006 editions of two state-owned and two privately owned newspapers. The articles comprised reports on vehicle crashes (37%), commentaries (33%), informational pieces (12%), reports on pedestrian injury (10%), and editorials (8%). There was little coverage of pedestrian injuries, which account for half of the traffic fatalities in Ghana, but only 22% of newspaper reports. Only two articles reported on seatbelt use. Reporting patterns were similar between public and private papers, but private papers more commonly recommended government action (50%) than did public papers (32%, p=0.006). It is concluded that Ghanaian papers provide detailed coverage of traffic injury. Areas for improvement include pedestrian injury and attention to preventable risk factors such as road risk factors, seatbelt use, speed control, and alcohol use.
TL;DR: A severe lack in interpretation abilities in children of facial expressions of dogs which could contribute to the high incidence of dog bites, especially in younger children is indicated.
Abstract: Almost half of school children reported that they were bitten (Beck & Jones,1985; Spiegel, 2000) and in other research, 20% of dog-owning parents reported their child bitten (Wilson, Dwyer and Bennett, 2003, see also Lakestani, Donaldson, Verga & Waran, 2006). Child-initiated interactions with the dog trigger up to 86 % of injuries at home. Recently, it was found that young children do not discriminate a dogs body signals, but look mainly at the dogs face (Lakestani et al., 2006). While there has been anecdotal evidence that children mistake an angry, teeth-baring dog face for a smiling one, there is to date no systematic empirical evidence on the misinterpretation of dogs facial expressions. We tested 4-, 5-, 6-year-old children and adults on neutral, aggressive and happy human and dog facial expressions. Results show that while adults make hardly any mistakes (less than 1%) on both stimulus types (dog and human faces), 69% of 4-year-olds interpreted aggressive dog faces as smiling and happy. Five-year-olds show 35% and 6-year-olds 25% misinterpretations whereas they are over 90% correct on all human facial expressions. This result indicates a severe lack in interpretation abilities in children of facial expressions of dogs which could contribute to the high incidence of dog bites, especially in younger children. Given this result, we can advise children and parents to prevent injuries and inform dog bite prevention programmes to help prevent further dog bite incidents.
TL;DR: The study showed that seatbelt use among vehicle occupants was low and further research into reasons for the non-use of restraints needs to be conducted so that these can be incorporated into programmes aimed at improving seatbelts use.
Abstract: Objective The use of seatbelts reduces the likelihood of death and severe injuries to crash-involved vehicle occupants by 45e60%. Several countries, including Nigeria, have laws mandating the use of seatbelts but compliance is not universal. This study was conducted to determine rates of use of seatbelts among vehicle occupants in Ibadan municipality. Design An observational study was conducted. A selected petrol station in each of the five local government areas in Ibadan municipality was used as an observation site. Observations were documented by trained research staff between 08:30 and 18:00 hours over a 6-day period. Results 5757 occupants in 2870 vehicles were observed. Approximately 90% of drivers were men. Driver seatbelts were installed in approximately 90% of vehicles. Overall seatbelt use was 18.7; 31.7% among drivers and 10.3% and 0.4% among front and rear-seated adults, respectively. Only one child (0.7%) was restrained. Significantly more female drivers 47.3% used their seatbelts compared with men, 30.3% (p<0.001). An adult passenger was more likely to be restrained when riding with a female driver (p¼0.007) and when the driver was restrained (p¼0.000). Conclusions The study showed that seatbelt use among vehicle occupants was low. Further research into reasons for the non-use of restraints needs to be conducted so that these can be incorporated into programmes aimed at improving seatbelt use.
TL;DR: Alcohol-involved fatal crash rates in young female drivers aged 19–24 years have increased, however, male drivers continue to surpass women in the number of alcohol- involved fatal crashes.
Abstract: Objective Young men have greater representation in fatal alcohol-related crashes. Recent studies of young women and risky behaviours have raised concerns about the implications this may have for alcohol-related fatal crashes. The objective of this study was to investigate the representation of young female drivers in US alcohol-involved fatal crashes (1995–2007) and to identify trends heralding future negative changes in crash profiles for young female drivers. Design Fatal crash data were obtained from the US National Highway Traffic Safety Administration Fatal Analysis Reporting System (FARS). Five age groups were analysed. The FARS multiple imputation dataset was used to estimate the proportion of drivers with blood alcohol, and variance estimates were corrected for the procedure. Linear regression was used to measure trends (1995–2007). Results 179 891 fatal crashes in all age groups occurred over the study period. The rate of involvement in fatal crashes for young drivers with positive blood alcohol concentrations (BAC) decreased for men and women aged 16 years but increased for women age 19–24 years. Young female drivers had a greater increase than young men in the proportion of alcohol-involved fatal crashes (3.1%, 95% CI 1.9 to 4.3% vs 1.2%, 95% CI 0.2 to 2.1%, p=0.02). Most of the increase occurred in drivers with BAC ≥0.15 g/dl. Drivers with higher BAC had markedly lower safety restraint use. Over time restraint use increased in all BAC groups studied. Conclusion Alcohol-involved fatal crash rates in young female drivers aged 19–24 years have increased. However, male drivers continue to surpass women in the number of alcohol-involved fatal crashes. Restraint use decreases markedly with increasing BAC.
TL;DR: This initiative includes a road traffic injury prevention component in the following countries: Brazil, Cambodia, China, Egypt, India, Kenya, Mexico, Russian Federation, Turkey, and Vietnam.
Abstract: In 2010, a consortium of six partners received funding from Bloomberg Philanthropies to conduct activities that would improve road safety in 10 low- and middle-income countries. Dubbed the Road Safety in 10 Countries Project—or RS10 for short—this initiative includes a road traffic injury prevention component in the following countries: Brazil, Cambodia, China, Egypt, India, Kenya, Mexico, Russian Federation, Turkey, and Vietnam (see box 1). It also includes trauma care in Kenya and India, and data systems improvement in Kenya and Egypt. RS10 will be implemented over the next 5 years (2010–14). The 10 countries were chosen based on the following criteria: road traffic fatalities per 100 000 population, population size, political will and human capacity.
### Box 1 Road Safety in 10 Countries Project (RS10) consortium partners
TL;DR: It is suggested that working in manufacturing industries and working with powered machines are the primary sources of severe hand injuries in hospitalised workers in economically active areas of the PRC.
Abstract: Objectives This study describes the type, location and severity of work-related acute traumatic hand injuries of 560 workers treated in 11 hospitals in three economically active cities in the People’s Republic of China (PRC) over a 2-year period. Methods A structured questionnaire was used to collect participant’s information. Log-linear and logistic models were constructed to identify factors associated with injury occurrence and severity, respectively. Results Participants (n¼560) had a mean age of 31.7 years (SD 10.5), 74.4% were men. 85.4% of participants were employed in manufacturing industries; 51.7% of 750 injuries were to the left hand. The index finger was injured most often and the most severe injury occurred to the right thumb. 68.3% of participants had only a single type of injury (29.7% crushes, 25.7% amputations and 18.5% fractures). Severe injuries occurred most often while working with food products (79.2% severe), furniture (72.2%), non-metallic mineral products (71.4%) and wood products (70.6%). Powered machines were involved in 59.5% of injuries. Injury frequency was associated with gender (male vs female, odds ratio (OR) 2.9, 95% CI 2.4 to 3.5) and company size (#100 vs >100 employees, OR 2.5, 95% CI 2.1 to 3.1). Injury severity was associated with gender (male vs female OR 0.6, 95% CI 0.4 to 0.9) and powered machine use (OR 2.2, 95% CI 1.3 to 3.7). Conclusions The present study suggests that working in manufacturing industries and working with powered machines are the primary sources of severe hand injuries in hospitalised workers in economically active areas of the PRC.
TL;DR: The data suggest that PTSD prevalence among injury victims decreases over time, and ignoring PTSD in burden-of-injury studies results in a considerable underestimation of the burden of injury.
Abstract: Background Psychological consequences such as post-traumatic stress disorder (PTSD) are currently neglected in burden-of-injury calculations Aim To assess the disease burden of PTSD due to unintentional injury and compare this health loss with physical injury consequences Methods From literature sources, the prevalence of PTSD at four follow-up periods ( 12 months) was estimated The uncertainty of the estimated PTSD prevalence was modelled by a Bayesian approach The prevalence rates were then linked to national data on unintentional injury, disability weights and duration to estimate the incidence and disability-adjusted life years (DALY) resulting from PTSD in addition to physical injury consequences Results The data suggest that PTSD prevalence among injury victims decreases over time The average PTSD prevalence at Conclusions Ignoring PTSD in burden-of-injury studies results in a considerable underestimation of the burden of injury This may affect resource allocation and the identification of important prevention priorities
TL;DR: Speed enforcement through fixed speed cameras is thus effective in medium–high-speed roads, although effectiveness could not be generalised to roads with lower speed limits and traffic lights.
Abstract: Objective To assess the effectiveness of speed cameras in reducing the numbers of crashes and people injured on the arterial roads of Barcelona, and to assess their long-term effectiveness on the beltway. Methods Time series analyses were performed separately for the arterial roads and the beltway. The stretches of arterial roads encompassing 500 m before and after the location of a speed camera were considered the enforced stretches, the remaining stretches of arterial roads being considered the comparison group. The outcome measures were the numbers of crashes and of people injured. Quasi-Poisson regression models were fitted, controlling for time trend, seasonality and implementation of other road safety measures. Results Both on the enforced and non-enforced arterial road stretches, the risks of crashes and people injured were similar in the two periods. On the beltway, reductions of 30% (95% CI 38% to 20%) and 26% (95% CI 36% to 14%) were observed, respectively. Conclusions Speed cameras do not reduce the numbers of crashes or people injured on the arterial roads of Barcelona. However, they are effective in the short and in the long-term on the beltway. Speed enforcement through fixed speed cameras is thus effective in medium–high-speed roads, although effectiveness could not be generalised to roads with lower speed limits and traffic lights.
TL;DR: There was no evidence for a decline within the injury cause-categories that should be prevented by these interventions from 2002 to 2007, and if these interventions were effective the associated injury causes would be in decline.
Abstract: Background Trampolines continue to be a major source of childhood injury. Objective To examine available data on trampoline injuries in order to determine the effectiveness of padding and enclosures. Design Trampoline injuries from the NEISS database from 2002 to 2007 were reclassified into five causecategories, to examine evidence for injury trends. Setting The ASTM trampoline standard recommendations for safety padding were upgraded in 1999 and enclosures were introduced in 1997. This is the first study to examine the impact of these changes. Patients The sampling frame comprises patients with NEISS product code ‘consumer trampolines’ (1233). A systematic sample of 360 patients each year is taken. Interventions The prominent interventions recommended by the ASTM are netting enclosures to prevent falling off and safety padding to cover frames and springs. Main outcome measures Proportion of injuries within each cause-category and trend estimates. Results There was no evidence for a decline within the injury cause-categories that should be prevented by these interventions from 2002 to 2007. Conclusions If these interventions were effective the associated injury causes would be in decline. Instead they remain close to half of all trampoline injuries with no significant change over the period of the study. Follow-up studies are proposed to determine the reasons. Given the number of injuries involved it is recommended that steps be taken to ensure these safety interventions or their equivalents are in place, work properly and remain effective for the life of consumer trampolines.
TL;DR: Evidence suggests that when used appropriately, rear-view cameras can mitigate the occurrence of backing crashes, particularly when paired with an appropriate sensor system.
Abstract: Context Backing crash injures can be severe; approximately 200 of the 2,500 reported injuries of this type per year to children under the age of 15 years result in death. Technology for assisting drivers when backing has limited success in preventing backing crashes. Objectives Two questions are addressed: Why is the reduction in backing crashes moderate when rear-view cameras are deployed? Could rear-view cameras augment sensor systems? Design 46 drivers (36 experimental, 10 control) completed 16 parking trials over 2 days (eight trials per day). Experimental participants were provided with a sensor camera system, controls were not. Three crash scenarios were introduced. Setting Parking facility at UMass Amherst, USA. Subjects 46 drivers (33 men, 13 women) average age 29 years, who were Massachusetts residents licensed within the USA for an average of 9.3 years. Interventions Vehicles equipped with a rear-view camera and sensor system-based parking aid. Main Outcome Measures Subject’s eye fixations while driving and researcher’s observation of collision with objects during backing. Results Only 20% of drivers looked at the rear-view camera before backing, and 88% of those did not crash. Of those who did not look at the rear-view camera before backing, 46% looked after the sensor warned the driver. Conclusions This study indicates that drivers not only attend to an audible warning, but will look at a rear-view camera if available. Evidence suggests that when used appropriately, rear-view cameras can mitigate the occurrence of backing crashes, particularly when paired with an appropriate sensor system.