Accidental injuries among the elderly within the Vienna community: Epidemiology,risk factors and preventive measures

Abstract

Unintentional injuries ('accidents’) among elderly people are a significant burden in public health because such accidents happen frequently and because the proportion of older age groups in the population will continue to rise during the coming decades. One aim of this study, which was done in Vienna, the capital of Austria, was to broaden the preventive concept, adding lifestyle and living conditions to already well-known risk factors following the health promotion approach. Furthermore, characteristics that predispose older residents to accidents should be identified in order to design preventive measures for reducing injuries in this age group.

809 interviews with people 60 years of age and over were conducted, concerning accidents, outcomes of accidents, physical fitness, drug intake, type of house or dwelling, equipment in the household incorporating safety features, psychological well-being and social relations. The information collected was used to draw cross-sectional comparisons between participants who reported having experienced at least one accident in the previous 12 months and those who did not. Furthermore, the accident incidents were classified into 2 groups: incidents without injuries and injurious accidents. The latter served as a base for the epidemiology of injuries for people 60 years of age and over within the Vienna community.

20% of all senior citizens suffer at least one unintentional injury every year, in addition to which 8% experience critical incidents (mostly falls) without injury. Most accidents occur at home or involve pedestrians in public traffic areas. Over 90% of all accidents are falls, and 20% result in fractures. The most important risk factors for accidents in the elderly are gender, increasing age, poor physical fitness and low physical activity, the type of household and household equipment, poor psychological well-being, low income and loneliness.

The findings regarding falls suggest some possible opportunities for reducing the risk of falls by improving buildings and dwellings of the elderly. A promising attempt at practical implementation of these findings is being conducted by the Vienna-based Austrian Institute for Home and Leisure Safety in cooperation with the Vienna City Council. These two organizations are implementing a long-term program that aims at mobilizing institutions and organizations involved in working with the elderly.     

Money Does Not Grow on Trees: An Argument for Usury

Usury, charging a higher interest rate than thought by some to be “fair,” has had and still has, a bad press. Historically, it was heavily punished. It was then, and all too often is now, thought to be exploitative. Yet, as even the most economically unsophisticated must realize, both sides of these transactions must necessarily gain at least in the ex ante sense, otherwise one or the other would refuse to enter into the deal in the first place. The present paper is an attempt to justify the practice of charging interest on loans, at any rate agreeable to both borrowers and lenders.     

A Bayesian Bioeconometric Model of Invasive Species Control: The Case of the Hemlock Woolly Adelgid

In this article we evaluate a US Forest Service plan to mitigate damages from an invasive insect on public, forested land. We develop a dynamic model of infestation and control to explicitly account for biological interactions, baseline conditions, and uncertainty, thus creating a more complete picture of policy impacts than a static cost benefit analysis could provide. We combine the results of the dynamic model with an empirical study of nonmarket forest benefits to create a bioeconomic model of ecosystem management. Estimating the empirical model in a Bayesian framework allows us to treat the economic coefficients of the dynamic model as random variables. We specify distributions for the biological parameters and examine the effects of both biological and economic uncertainty on the predictive distribution of net benefits. We find that the net benefits of the program are positive, and that uncertainty in the biological model contributes substantially more to the variance of our estimate than does uncertainty over the valuation of the resource.     

An integrated approach for ex-ante evaluation of public policies for sustainable agriculture at landscape level

An integrated methodological framework for ex-ante evaluation and planning of public policies for sustainable agriculture at agro-landscape level is proposed. The components of the framework are to: (1) determine the private, i.e. farmers’, and public benefits associated to agro-landscapes, consisting of an agricultural land-use system, according to its performance for several market and non-market functions. Market forces determine the market benefits and preferences of society the non-market benefits; (2) explore and select potential sustainable agro-landscapes based on the private and public benefits associated with possible land-use alternatives; (3) define efficient public policy mechanisms for improving social net benefit of agro-landscapes.The framework is illustrated with a case study in a small dairy farming dominated agro-landscape in The Netherlands, with gross margin, landscape quality, nature value and environmental health as the analysed ecosystem functions. Alternative landscapes consisting of hedgerow configurations and grassland management practices were explored, yielding a set of alternatives representing the solution space in terms of change in private and public benefits. Policy mechanisms were defined to move from the current to a desired landscape based on changes in social net benefits. Moreover, the necessity of a modification in the current agri-environmental support was analysed for each landscape. The analysis considered all farmers in the agro-landscape jointly. The results for the case study showed potential prototypes of landscapes and their performance compared to the current landscape. Extension was the most efficient policy mechanism to promote the change to the socially optimum landscape alternative.