Long-term mortality following injury in working-age adults: a systematic review

Priorities for prevention activities and planning for services depend on comprehensive knowledge of the distribution of the injury-related burden in the community. The aim of this systematic review was to quantify the effect of being injured, compared with not being injured, on long-term mortality in working age adults. Cohort studies were selected that were population-based, measured mortality post-discharge from inpatient treatment, included a non-injured comparison group and related to working-age adults. Data synthesis was in tabular and text form with a meta-analysis not being possible because of the heterogeneity between studies. Eleven studies met the inclusion criteria. All studies found an overall positive association between injury and increased mortality. While the greatest excess mortality was evident during the initial period post-injury, increased mortality was shown in some studies to persist for up to 40 years after injury. Due to the limited number of injury types studied and heterogeneity between studies, there is insufficient published evidence on which to calculate population estimates of long-term mortality, where injury is a component cause. The review does suggest there is considerable excess mortality following injury that is not accounted for in current methods of quantifying injury burden, and is not used to assess quality and effectiveness of trauma care.     

An analysis of the intra-firm sales activities of Japanese multinational enterprises in the United States: 1977 to 1989

This paper examines the activities of the largest Japanese multinational enterprises (MNEs) operating in the United States by looking at data on exports, imports, and intra-firm trade between the Japanese subsidiaries in the United States and their parent and other foreign groups. It also examines how much of the domestic sales in the United States are accounted for by local production of the Japanese subsidiaries. Sales data provide an indication of the advantages of being multinational, which are mirrored in the growth of the post-investment sales of overseas units (both manufacturing and non-manufacturing). Data on the flows and stocks of foreign direct investment (FDI) represent the initial decisions to undertake FDI and largely ignore the learning effects of having overseas production.The authors are from the City University of Hong Kong and NORTACK Software Limited. We would like to thank the Editor, Dr Leung Hing-Man, the anonymous referees, and Don Daly, Wendy Dobson, Hiroaki Izumi, Terutomo Ozawa, Alan M Rugman and Rob Tran for their helpful comments. All errors and omissions, however, remain the responsibility of the authors.     

Competition in the electricity industry in England and Wales

When the electricity industry was privatized, the governmentmade structural changes to encourage competition in generationand in supply to consumers. The conventional power stationswere only divided between two companies, however, and we showthat duopolistic competition in an unregulated spot market mightimply undesirably high prices. Most sales are hedged in thecontract market, which makes the spot market more competitive,and a realistic threat of entry could also force generatorsto keep their prices down. In the event, a large amount of entrytook place, supported by the regional electricity companies'franchise monopoly over smaller consumers. That monopoly endsin 1998, so that further entry might become very difficult,while competition between firms already in the generation marketis still limited. Vertical integration between the major generatorsand regional electricity companies might make entry even harder,and should be blocked until the industry is more competitive.     

Indicators of injury burden: which types are the most important?

Injury indicators are used for monitoring the impact of injury prevention initiatives on the population burden of injury. The object of the present study was to identify the types of injury responsible for the major component of the population health burden of injury in a large cohort in Manitoba, Canada. Injury cases (ICD-9-CM 800-995) aged 18-64 years were identified from all Manitoba hospital data between 1988 and 1991. Morbidity data were obtained from hospital discharge abstracts 12 months prior to date of injury and for 12 months post-injury. Outcomes for individuals were calculated as the difference pre- and post-injury in hospital inpatient days. Death outcomes in the 12 months post-injury were obtained by linking the cohort with the population registry. Summed outcomes across the population were stratified into injury types based on the International Code of Diseases (ICD) code of the index injury. Outcomes were also stratified by injury severity score categories where the injury severity score was obtained using ICDMAP-90. When ranked by contribution to the cohort's cumulative hospital inpatient days in the 12 months post-injury, the six most common ICD subchapter groups accounted for 65% of the total inpatient days. These six injury types also accounted for 62% of the total number of deaths in this cohort in 12 months after injury. The suggested injury types to use as indicators of burden include fracture of the lower limb, fracture of the head and neck, poisonings, intracranial injury, fracture of the upper limb, and fracture of skull.     

How well do anatomical-based injury severity scores predict health service use in the 12 months after injury?

There is an acknowledged need for valid and reliable injury scores, suitable for use at the population level, which can accurately predict the long-term outcome of injury. The objective was to quantify the extent to which the abbreviated injury severity score (AIS) and the functional capacity index score (FCI) predict use of health services in the 12 months following an injury event. A cohort of injured people (ICD-9-CM 800-995) aged 18 - 64 years was identified from Manitoba hospital discharge abstracts from January 1988 to December 1991. For each member of the cohort whose injuries could be mapped to an abbreviated injury scale unique identifier, a maximum AIS (maxAIS) and a maximum FCI (maxFCI) were obtained. The cohort was linked with hospital discharge abstracts, physicians' claims and deaths from the population registry for the 12 months following injury. Negative binomial regression was used to model the relationships between the severity scores and the three outcome measures, while controlling for potential confounding variables. In total, 20 677 (97%) eligible cases were identified, of which 16 834 (81%) could be assigned a maxAIS and 15 823 (77%) a maxFCI. MaxAIS and maxFCI were significantly associated with total days in hospital following injury, but explained little of the variation in any of the health service use outcome variables (maxAIS, partial pseudo r2 ranging from < 0.001 to 0.041; and maxFCI, partial pseudo r2 ranging from < 0.001 to 0.018). It was concluded that anatomical damage is only partly responsible for long-term injury outcome. Additional variables would need to be included in predictive models of health outcomes of injury before these models could be reliable.     

A transactions data analysis of nonsynchronous trading

Weekly returns of stock portfolios exhibit substantial autocorrelation.Analytical studies suggest that nonsynchronous trading is capableof explaining from 5% to 65% of the autocorrelation. The varyingimportance of nonsynchronous trading in these studies arisesprimarily from differing assumptions regarding nontrading periodsof stocks. We simulate the effects of nonsynchronous tradingby sampling stock returns from a return generating process usingtransactions data to obtain the precise time of each stock'slast trade. We find that simulated weekly portfolio returnsexhibit autocorrelations that are roughly 25% that of theirobserved (CRSP) weekly returns.     

Inflatable rescue boat-related injuries in Queensland surf lifesavers: the epidemiology - biomechanics interface

The objective was to describe the relationship between epidemiological and biomechanical factors in the causal pathway of inflatable rescue boat (IRB)-related injuries in Australian surf lifesavers; to develop epidemiological and biomechanical methodologies and measurement instruments that identify and measure the risk factors, for use in future epidemiological studies. Epidemiological and biomechanical models of injury causation were combined. Host, agent and environmental factors that influenced total available force for transfer to host were specified. Measurement instruments for each of the specified risk factors were developed. Instruments were piloted in a volunteer sample of surf lifesavers. Participant characteristics were recorded using demographic questionnaires; IRB operating techniques were recorded using a custom-made on-board camera (Grand RF-Guard) and images of operating techniques were coded by two independent observers. Ground reaction forces transmitted to the host through the lifesaver's feet at the time of wave impact were measured using a custom-built piezoelectric force platform. The demographic questionnaire was found practical; the on-board camera functioned successfully within the target environment. Agreement between independent coders of IRB operating technique images was significant (p < 0.001) with Kappa values ranging from 0.5 to 0.7. Biomechanical instruments performed successfully in the target environment. Peak biomechanical forces were 415.6N (left foot) and 252.9N (right foot). This study defines the relationship between epidemiological and biomechanical factors in modifying the risk of IRB-related injury in a population of surf lifesavers. Preliminary feasibility of combining epidemiological and biomechanical information has been demonstrated. Further testing of the proposed model and measurement instruments is required.     

马克思主义的最高命题与中国共产党人的伟大实践

在马克思主义的经典理论中,人的全面发展理论是其重要的组成部分,而其核心：“一切人自由而全面的发展”则是马克思主义的最高命题。坚持马克思主义,首先应当坚持马克思主义的这一根本价值和最高命题。中国共产党人在中国革命与社会主义建设的进程中,将马克思主义与中国实际相结合,通过艰难探索,丰富和发展了人的全面发展理论。历代中央领导集体在践行这一最高命题上都作出了贡献,尤其是新一代中央领导集体在党的十六大以来提出了科学发展观和构建社会主义和谐社会等一系列重大战略思想,对马克思主义人的全面发展理论再度进行理论创新,在践行马克思主义最高命题上开辟了新道路。