Road safety determinants in low and middle income countries

The objective of this article is to summarize and review the literature on the determinants of road traffic injuries and fatalities, to identify the relevant research gaps in particular for low and middle income countries. We also present a cross-country analysis of the determinants of road traffic injuries and fatalities that take into account a wide range of potential environmental, economic and social factors. The present study focused on differences based on the level of development. The goal was to identify relevant commonalities that may assist in the creation of road safety policies common to countries at a similar level of development. The countries were divided according to the level of gross national income per capita, and these income-level groups were the primary units of interest. The results presented here focus on the differences by income level.     

A critical appraisal of the reporting quality of published randomized controlled trials in the fall injuries

To evaluate the quality of reporting in published randomized controlled trials (RTCs) in the field of fall injuries. The 188 RTCs published between 2001 and 2011, indexed in EMBASE and Medline databases were extracted through searching by appropriate keywords and EMTree classification terms. The evaluation trustworthiness was assured through parallel evaluations of two experts in epidemiology and biostatistics. About 40%–75% of papers had problems in reporting random allocation method, allocation concealment, random allocation implementation, blinding and similarity among groups, intention to treat and balancing benefits and harms. Moreover, at least 10% of papers inappropriately/not reported the design, protocol violations, sample size justification, subgroup/adjusted analyses, presenting flow diagram, drop outs, recruitment time, baseline data, suitable effect size on outcome, ancillary analyses, limitations and generalizability. Considering the shortcomings found and due to the importance of the RCTs for fall injury prevention programmes, their reporting quality should be improved.     

Demographic determinants of incident experience and risk perception: do high-risk groups accurately perceive themselves as high-risk?

This paper analyzes demographic determinants of incident experience and risk perception, as well as the relationship between the two, for eight different risk domains. Analyses were conducted by merging the results of a Swedish population-based survey, which includes approximately 15,000 individuals, with demographic and socio-economic register data. Being male was associated with higher incident experience yet a lower risk perception for nearly all risk domains. Lower socioeconomic status was associated with higher incident experience for falls, and being a victim of violence but lower incident experience for road traffic accidents. Lower socioeconomic status was also associated with higher risk perception for falls. On aggregate, ranking the different domains, respondents’ risk perception was in almost perfect correspondence to the ranking of actual incident experience, with the exception that the risk of being a victim of violence is ranked higher than indicated by actual incident experience. On a demographic group level, men and highly educated respondents perceive their risks to be lower than what is expected considering their actual incident experience.     

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.     

Adolescent injuries in relation to economic status: An international perspective

The primary objective of the study was to examine the relationship between patterns in car-to-car crashes involving young drivers and car and driver characteristics and the research design was a national register-based prospective cohort study. Individual records in a cohort born 1970 – 1972 are linked to road-traffic-crash data (1988 – 2000). Subjects' first police-registered two-car crash leading to severe or fatal injury (n = 4875) are identified. Typical crash patterns are highlighted and associations between pattern and both car and individual socio-demographic characteristics are tested. Four crash patterns are highlighted. Male drivers and those with lower educational attainment are over-represented in all patterns. Pattern-based risk levels vary considerably according to car safety level and driver's age at time of injury and socio-economic status. Crash patterns might be considered in young adult driver education systems, bearing in mind the consistent higher risks of male drivers and of drivers with lower educational attainment.     

Injuries increase the amputee burden at the prosthesis centre: a 2-year retrospective survey of amputees in a low-income setting

The aim of this study is to survey different types of injuries as the cause for prosthesis fitting in the Institute of Physical Medicine and Rehabilitation (IPM&R). This retrospective chart review was conducted at the IPM&R at the Dow University of Health Sciences, from the year 2007 till 2009. We selected all amputees who got enrolled in our institute for prosthesis fitting with major amputations, during the above mentioned period of time. Informed verbal consent was taken from each patient before recording their data at the IPM&R. Anonymity has been maintained. Data for this study was collected through a structured questionnaire, variables included: gender, age, town of origin, cause of amputation, level of amputation, limb involvement (unilateral or bilateral), level and causes of amputations. The data entry and analysis were done on SPSS (Statistical Package of Social Sciences) version 16.0. Of the amputee burden of our study, 55.9% was due to trauma, which is a preventable cause of disability. This is mostly affecting men in the productive age group. New strategies need to be devised in order to alleviate the burden of amputations resulting from preventable injuries.     

The perception of fire risk by older people and its impact on relevant fire safety education

Accidents due to ‘fire and flames’ are second only to “falls” as the most important cause of accidental death in the homes of elderly individuals throughout the United Kingdom. This study aims to ascertain whether older people are receiving fire accident advice appropriate to their needs. A questionnaire addressing the issues of risk perception, fire preventative action and access to fire safety information was distributed to 1100 randomly selected members of the ‘Thousand Elders’ (a nation-wide consumer group established by the Centre for Applied Gerontology at The University of Birmingham, comprising people above the age of 50 years). Eight hundred and four questionnaires were returned and were analysed using the Statistical Package for Social Sciences. Fire risk was perceived as far less of an immediate threat than the danger of a personal attack by an intruder in the home. Recognition of fire risk and the effectiveness of fire safety measures did not result directly in safety appliances being fitted. The majority of ‘Elders’ had received no fire-fighting training, yet more than half felt confident in tackling a small fire. Neither did experience of a fire in the home necessarily increase action towards safety precautions. The majority had not been exposed to a fire safety campaign in the past 12 months. On exposure to a campaign, the impact towards fire safety was positive. The educational process should aim to close the gap between the recognition of the need for fire safety precautions and the implementation of fire safety measures. The key to effective fire prevention amongst older people depends upon: Information, Training and Support, i.e., relevant information supported by practical help and subsequent practical training in-situ by trusted community figures.     

Ability of crime,demographic and business data to forecast areas of increased violence

ABSTRACT

Identifying geographic areas and time periods of increased violence is of considerable importance in prevention planning. This study compared the performance of multiple data sources to prospectively forecast areas of increased interpersonal violence. We used 2011–2014 data from a large metropolitan county on interpersonal violence (homicide, assault, rape and robbery) and forecasted violence at the level of census block-groups and over a one-month moving time window. Inputs to a Random Forest model included historical crime records from the police department, demographic data from the US Census Bureau, and administrative data on licensed businesses. Among 279 block groups, a model utilizing all data sources was found to prospectively improve the identification of the top 5% most violent block-group months (positive predictive value = 52.1%; negative predictive value = 97.5%; sensitivity = 43.4%; specificity = 98.2%). Predictive modelling with simple inputs can help communities more efficiently focus violence prevention resources geographically.     

Estimating road traffic injuries in Jinja district,Uganda, using the capture-recapture method

ABSTRACT

Road traffic injuries (RTIs) are commonly under-reported in low-and-medium-income countries. This study aimed to estimate the number of RTIs and determine the magnitude of under-reporting by traffic police and hospital registries. A two-source capture-recapture method was applied to RTI data from police and hospital registries. Seven matching variables; sex of the injured, date, place, time, day of crash and road user type were used to get the matched cases. Police independently reported 46 RTIs and the hospitals reported 206 RTIs. Using the capture-recapture analysis, both sources estimated 313 RTIs (95% CI 273–343). The police registry captured 14.4% of the estimated number of RTIs and the hospitals captured 60.4%. The estimated number of RTIs was higher than reported by either the police or the hospitals alone. Neither the police nor the hospitals provided accurate data on RTIs, calling for the strengthening of both sources of data.     

Knowledge,beliefs and attitudes of squash venue operators relating to use of protective eyewear

Sports venues are in a position to potentially influence the safety practices of their patrons. This study examined the knowledge, beliefs and attitudes of venue operators that could influence the use of protective eyewear by squash players. A 50% random sample of all private and public squash venues affiliated with the Victorian Squash Federation in metropolitan Melbourne was selected. Face-to-face interviews were conducted with 15 squash venue operators during August 2001. Interviews were transcribed and content and thematic analyses were performed. The content of the interviews covered five topics: (1) overall injury risk perception, (2) eye injury occurrence, (3) knowledge, behaviors, attitudes and beliefs associated with protective eyewear, (4) compulsory protective eyewear and (5) availability of protective eyewear at venues. Venue operators were mainly concerned with the severe nature of eye injuries, rather than the relatively low incidence of these injuries. Some venue operators believed that players should wear any eyewear, rather than none at all, and believed that more players should use protective eyewear. Generally, they did not believe that players with higher levels of experience and expertise needed to wear protective eyewear when playing. Only six venues had at least one type of eyewear available for players to hire or borrow or to purchase. Operators expressed a desire to be informed about correct protective eyewear. Appropriate protective eyewear is not readily available at squash venues. Better-informed venue operators may be more likely to provide suitable protective eyewear.