The burden of road traffic injuries in Kermanshah Province,Iran, in 2010–2011: GBD 2010 method

Deaths, injuries and disabilities resulting from road traffic injuries (RTIs) are a public health major concern. This study aims to calculate the burden of RTIs in Kermanshah Province in Iran. In this study to determine the years of life lost (YLL) related to RTIs, the National Death Registration and Forensics Medicine census data were employed. We use forensic medicine data to calculate the incidence of non-fatal injuries and years lost due to disability (YLD). The cause of death and non-fatal injuries was classified using ICD-10 codes and 23 groupes of global burden of diseases (GBD) 2010. The disability-adjusted life year (DALY) estimated on the guidelines of the GBD 2010 and age and sex structure was taken from the National Statistic Center for the year 2010. Overall, 70.8% of the subjects were males. The fatal and non-fatal injury rates of RTI were 51.3 and 283.6 per 100,000 persons, respectively. YLLs and YLDs were 46613 (24.5 per 1000) and 3405 (1.8 per 1000) in both sexes, respectively. The disability adjusted life years were 40711 in males, 9306 in females and 50018 in both sexes (42.5, 9.8 and 26.3 per 1000, respectively). More than 93% of DALY was from YLL (24.5 per 1000), with a small proportion for YLD (1.8 per 1000). Accounting for more than 50,000 DALY attributed to RTIs, traffic injuries is a major public health and socioeconomic problem in Kermanshah. Designing cost-effective interventions based on comprehensive and multi-sectoral programmes at the national and provincial levels can save many lives and resources that are lost every year. Undoubtedly, establishing a surveillance system at the sub-national level and measuring the burden of injuries, as in this study, can help policy-makers and planners in lessening the burden of RTIs.     

Clothing-related motorcycle injuries in Pakistan: findings from a surveillance study

This study aims to assess the burden and patterns of clothing-related motorcycle injuries in Karachi, Pakistan. Data were extracted from an ongoing traffic injury surveillance system. In three years (2007–2009), out of 99155 road traffic injury cases there were 986 (0.9%) cases of clothing-related motorcycle injuries. Most cases were females (73.9%) and pillion riders (80.6%). The crashes involving clothing-related injuries were mostly single vehicle (98.5%), and largely resulted in injuries to the external body (60.3%), limbs (51.0%), head (41.5%) and face (35.9%). One-third of injuries were either moderate (26.7%) or severe (10.2%) while 10 (1.01%) deaths were reported. Female gender (11.4%), age ≥ 45 years (19.4%), pillion riding (11.3%) and crashes occurring at intersections (12.3%) were more likely to result in moderate or severe injury as compared to other users (P < 0.001). Injuries due to entanglement of loose fitting clothing in motorcycles are not uncommon in Karachi. Awareness campaigns for prevention of such injuries may involve promotion of appropriate dressing for motorcycle riding including close wrapping of clothes and encouraging installations of covers on the rear wheels and drive chains.     

Pillion riders' cloth related injuries and helmet wearing patterns: a study of Lahore,Pakistan

This study aims at investigating the burden and pattern of clothing related pillion riders' injuries and their helmet wearing pattern in Lahore, Pakistan. Data were collected for nine months (July 2013 to March 2014), reporting 13,248 motorcycle related injuries, out of which 8751 (66%) cases were related to the clothing related pillion riders' injuries. Out of these injuries 10.30% were severe injuries which can be prevented or reduced by proper safety measure, e.g. wearing helmet. It was also found that most of the fatalities were not wearing helmet. Injuries due to wearing of loose fitting clothes and absence of helmet are not uncommon in Pakistan and other underdeveloped parts of the world. Such accidents may be reduced by creating awareness and safety sense in the riders, where use of safe dress and helmet should be encouraged in order to avoid such fatal damages.     

Ethical Climates and Workplace Safety Behaviors: An Empirical Investigation

In this article, the important but neglected link between workplace safety-enhancing behavior and ethics is explored. Using data from 237 employees from five manufacturing plants in the Midwest, we investigated how specific local ethical climate types are linked to incidences of injuries and two types of safety-enhancing behaviors: safety compliance and safety participation. It was hypothesized that egoist climates are positively related to injuries and negatively related to safety-enhancing behaviors. In contrast, it is proposed that both benevolent and principled climates have negative relationships with injuries and positive relationships with safety-enhancing behaviors. Results provided support only for our principled climate types while benevolence has the desired negative relationship with injuries. Egoism and benevolence are not related to safety-enhancing behaviors. Theoretical and practical implications of findings are discussed. K. Praveen Parboteeah (Ph.D. Washington State University) is an Associate Professor of International Management in the Department of Management, University of Wisconsin – Whitewater. Parboteeah's research interests include international management, ethics, religion and technology and innovation management. He has published articles in numerous acadamic journals including Academy of Management Journal, Organization Science, Decision Sciences, Small Group Research, Journal of World Business, Management International Review, R&D Management and Journal of Engineering and Technology Management. Edward Andrew Kapp is an Assistant Professor in the Department of Occupational and Environmental Safety & Health at the University of Wisconsin-Whitewater. He received his Ph.D. in Industrial Engineering from the University of Wisconsin-Madision. Prior to his position at UW-Whitewater he worked in government, consulting, and private industry. Currently he teaches graduate and undergraduate courses in occupational safety, environmental health & safety management, and environmental and safety law. Dr. Kapp's research is in the area of environmental health & safety management, focusing on the influence of climate and leadership on safety performance.     

Injuries and their burden in insured construction workers in Iran, 2012

The present study used disability adjusted life years (DALY) to estimate the burden of external cause of injuries in construction workers insured in Iran in 2012. The Global Burden of Disease method (2010) was used to estimate the years of life lost due to death (YLL) and years of life lost due to disability (YLD). DALY was calculated as the sum of YLL and YLD. There were 5352 injured construction workers in Iran (11.25 individuals per 1000). Falling was the most common incidence and included 2490 individuals (46.53%). Totally, DALY was estimated 18,557 years for all age groups and both genders including 17,821 YLD (96%) and 736 YLL (4%). The DALY related to construction work is high in Iran and it has notably affected the young. Hence more preventive methods should be applied to reduce the overall burden of specific external cause of injuries especially in young and inexperienced workers.     

The toll of traffic-related fatalities in a metropolitan Italian area through the experience of the Department of Legal Medicine

Despite the introduction of new traffic laws in Italy, traffic-related deaths are still a huge burden. The study presents data and medico-legal issues behind traffic deaths in Milan between 2001 and 2012 (1506 traffic-related deaths). Data were collected from the database of the Department of Legal Medicine: 79.4% males and 20.6% females (mean age 44.14). The target group concerned traumatic deaths as a consequence of the accident as well as deaths not directly related to an accident. Although 6.1% were non-traumatic deaths (cause of death unconnected to the accident, i.e. because of a heart attack, or when death occurred after survival and cause of death was not related certainly to the accident), multiple skeletal/visceral injuries were the main cause of death (57.9%), occurring in motorcyclists the most (63.7%). Injuries to the skull and brain were the second cause of death (25.9%). Victims were mostly males (79.4%) and drivers (77.6%). Fifty-five per cent were deaths on-scene, while 45% survived. Other variables were also considered: medications, medical history, and drugs/alcohol/smoke. A downward trend in traffic-related fatalities was evident, but the toll is still high. This study should be a glimpse at the actual situation, since it is indicative of a metropolitan area where autopsies are systematically performed.     

Pedestrians: the daily underestimated victims on the road

Traffic-related pedestrian injuries (TRPI) are vulnerable to road users. In this study, we aimed to evaluate the demographic pattern of injury and outcome of TRPI. Patients with TRPI admitted between November 2007 and March 2010 to the only level 1 trauma centre in Qatar were included. A retrospective analysis was based on medical records and Emergency Medical Services run sheets. The spreadsheet included demographic data and pre-hospital transport, service admissions and injuries by system and mortality. Of 4077 patients who were admitted, 420 (10.3%) had TRPI. The mode of transportation included ambulances (91%), private vehicles (6%) and helicopters (3%). The direct dispositions were trauma intensive care units (38%), surgical wards (42%) and operating rooms (17%). Patients were classified according to Injury Severity Score (1–8 in 28%, 9–15 in 25%, 16–24 in 20% and 25–75 in 17% cases). Multisystem injuries were most characteristic. Of 804 injures, injury of extremities was predominant followed by head, thorax and abdomen. The overall mortality was 8%. Pedestrian injuries are a significant cause of serious trauma in Qatar. Motor vehicle/pedestrian interface contributes to this ongoing public health problem. Reducing pedestrian trauma requires recognition of the problem and implementing programmes to mitigate these largely preventable injuries.     

Trends and characteristics of injuries in the State of Qatar: hospital-based study

Injuries account for a large burden of mortality and morbidity in the State of Qatar. No comprehensive study has been conducted on all types of injuries in the State of Qatar. The objective of this study was to determine the trend in the number, incidence and pattern of injuries in the State of Qatar. This hospital-based study is a retrospective analysis of 53,366 patients treated at the accident and emergency and trauma centres for injuries during the period from 2006 to 2010. Injuries were determined according to the ICD 10 criteria. The details of the entire trauma patients who were involved in occupational/domestic injuries were extracted from the database of the Emergency Medical Services (EMS), Hamad Medical Corporation. Our results demonstrated that the rates of injury remained relatively stable in the State of Qatar over the five–year period. Those most at risk of injury were non-Qatari males who were below 30 years. Road traffic accidents (RTA) (36.7%) followed by falls causing back injuries (11.0%) were the most common types of injuries during the period. Most of the injuries occurred at the head for both males (17.7%) and females (13.5%); this was consistently the case across all of the age groups. The greatest proportion of RTA (21.2%), industrial machinery injuries (16.4%), construction injuries (15.5%), recreational sporting injuries (20.5%) and beach/sea/ocean injuries (15.0%) resulted in head injuries. Intervention efforts need to be aimed at reducing occupational injuries, RTA injuries and work–related hazards in the State of Qatar.     

Trends in road traffic crashes and associated injury and fatality in the People’s Republic of China, 1951–1999

The burden of road traffic injuries in the People’s Republic of China is increasing as evidenced by trends since 1951. Data from the National Statistical Office, Ministry of Communications and the Traffic Administration Bureau were analyzed. Absolute numbers of crashes, fatalities, and injuries, as well as fatalities per 100,000 population and motorization (number of vehicles per 1000 population) were used as indices to measure trends. Regional variations in trends and the characteristics of people injured or killed were also analyzed. Road traffic crashes increased 68- fold, from around 6000 in 1951 to 413,000 in 1999. Excessive speed was the main reported cause of the crashes. The injuries increased 56-fold – from around 5000 to 286,000 – and fatalities 97-fold – from 852 to around 84,000 – over the same period. The crash, fatality and injury rates also increased after 1985, due to increased motorization spurred by rapid economic growth. The number of four-wheel motor vehicles increased from 60,000 in 1951 to just under a million four-wheel motor vehicles in 1975 and to 10 million in 1987. The number of four-wheel motor vehicles then rose to 50 million in 1999, with an additional 30 million motorcycles. The increase in motorization and fatalities affected all the provinces. Road traffic injuries are the leading cause of death for populations up to the age of 45 years and the leading cause of working-life years lost in China.     

Bunk bed injuries in Australia: the case for a mandatory safety standard

Bunk beds have long been recognised as a potential source of injury to children. This study was undertaken to establish an evidence base for a proposed injury reduction program and to determine whether or not there is a case for a mandatory safety standard. Recent literature on bunk bed safety was reviewed to provide an overview of the injury issues involved. Major sources of relevant Australian and international data were identified and the available data summarised. An in-depth analysis of Victorian data was undertaken to identify the nature and severity of injuries sustained and any patterns or trends, including age profiles. It is estimated that, in Australia, in the under fifteen age-group, there are at least 2,100 bunk bed-related injuries treated annually by hospital emergency departments. This represents a rate of about 50 injuries per 100,000 age-specific population. The majority of these injuries (86%) occur in children under the age of 10 years with injuries peaking in the 5-9 year age-group. The main cause of non-fatal injury is falls from the top bunk resulting in a fracture (33%), mainly to the upper extremity (75%). There have been at least two deaths from asphyxia in Australia in the past 10 years, due to entrapment in the bunk structure. It is clear from the current evidence that bunk bed injuries are a significant problem in Australia and represent a life-threatening hazard to young children in particular. The existing voluntary Australian/New Zealand Standard adequately addresses the safety issues raised by the examination of the literature and the analysis of the injury data. It is also clear that, in Australia, voluntary standards and the market place have been ineffective in achieving compliance. It is therefore recommended that the Australian Standard be made mandatory in an effort to significantly improve the safety of bunk beds in Australia.     

Promoting youth occupant restraint based on need

Motor vehicle crashes are a leading cause of death for youth. Appropriate occupant protection significantly reduces these preventable injuries. Secondary field observation survey records were studied to identify populations that would most likely benefit from youth occupant protection programs. Multivariate regression analysis showed that drivers of youth between 4 and 14 years were in need of programs promoting youth and driver occupant restraint use. When these drivers were using seat belts, it was 35 times more likely they had youth occupants in safety restraints. A focus on pickup truck drivers may also give these programs greater efficacy in increasing youth restraint use. This study was limited to a single state, but the approach should be transferable to other jurisdictions where youth occupant protection field observation studies are conducted.     

Neck injuries among the elderly in Sweden

Neck injuries are some of the most important injuries as they have the potential to influence the spinal cord. A previous national survey of neck injuries in Sweden revealed that injury incidence was increasing for the population over 65 years of age, although it was decreasing for the population as a whole. The aim of this study was therefore to further clarify the magnitude, severity, and external causes of neck injuries in the elderly people in Sweden. A national incidence study, with focus on the age group above 65 years, was undertaken with data from the injury surveillance program at the Swedish National Board of Health and Welfare. The investigation includes cervical vertebral fractures reported between 1987 and 1999, and cervical soft tissue injuries from 1997 to 1999. Data in the hospital discharge register were reported in ICD9 from 1987 to 1996, while data from 1997 to 1999 were reported in ICD10. During the study period 4168 cervical injuries occurred of which 341 were fatal. People above 65 years of age made up 17% of the population and sustained 30% of all cervical injuries and 43% of all fatal cervical injuries. Half of the cervical injuries were axis (C2) fractures. Lower vertebral fractures occurred in 16% of the cases and atlas (C1) fractures in 11%. The cervical soft tissue injuries amount to 19% of all injuries. Fall accidents account for the majority (71%) of the accidents. There is an increasing trend for fall accidents resulting in neck injuries. The male population has a higher incidence for neck fractures than females, disregarding the external cause of injury. The upper cervical injuries are the most common, have the longest hospital treatments, and seem to be caused mainly by low energy falls. Further research is needed to understand the mechanisms of these injuries and in this aspect engineering could contribute with valuable knowledge, through accident simulations with numerical models. The increasing incidence of fall injuries calls for further preventive actions. The public sector should implement preventive strategies to reduce the number of extrinsic accidents, while the health care sector should focus on preventing intrinsic accidents with individual actions for each patient.     

Cervical injuries in Sweden,a national survey of patient data from 1987 to 1999

Neck injuries are one of the most important injuries as they have the potential to influence the spinal cord. Data from most parts of the world are not sufficient to define a comprehensive view of mortality, morbidity, disability and handicap due to neck injuries. In Sweden, there are no data on the incidence of neck injuries. The aim of this study is to define the national incidence and causes of neck injuries in Sweden. An incidence study was undertaken with data from the injury surveillance program at the Swedish National Board of Health and Welfare. The investigation includes cervical vertebral fractures reported between 1987 and 1999, and cervical soft tissue injuries over a period of three years, from 1997 to 1999. Data between 1987 and 1996 were reported in ICD 9, while data from 1997 to 1999 were reported in ICD 10. During the study period, 14,310 non-fatal and 782 fatal cervical injuries occurred. A decreasing incidence for cervical fractures can be seen for the Swedish population, except for the elderly that have a slight increase in incidence. The incidence for cervical soft tissue injuries is almost constant. Cervical fractures demand longer periods of hospitalization than the soft tissue injuries. Transportation-related cervical fractures have dropped since 1991, while soft tissue injuries increased slowly between 1997 and 1999. Fall accidents are now the largest external cause of cervical fractures, and the population above 65 years accounts for almost 50% of the fall accidents. The male population has a higher incidence of cervical fractures, disregarding age. It is concluded that safety programs for transportation-related injuries in Sweden have been successful, while fall accidents are still substantial. Much more can be done to prevent neck injuries; especially to reduce the number of transportation-related cervical soft tissue injuries and fall injuries in the elderly population.     

并购式内创业中的人力资源整合水平和模式研究

When firms start intrapreneurship by merger or acquisition, the level and pattern of human resource integration becomes a critical issue. However, extant literature has paid scant attentions to this issue. Drawing on the previous researches on M&A intrapreneurship, the present article collected primary data of the level and pattern of human resource integration in M&A intrapreneurship by means of in-depth interviews and used content analysis method to structurally analyze the data. The results showed that enterprises engaging in M&A intrapreneurship generally choose a high or intermediate level of HR integration. Specifically, enterprises at high level of HR integration tend to absorb employees from the acquired directly or recruit afresh employees, while enterprises at intermediate level of HR integration are inclined to adopt an agent-type of integration pattern. Translated from Zhejiang daxue xuebao(Renwen shehui kexueban) 浙江大学学报(人文社会科学版) (Journal of Zhejiang University (Humanities and Social Sciences)), 2007, 37(1): 178–189     

New directions in injury surveillance: Development of a model for continuous monitoring of direct medical costs

Information on the costs of injuries is an important additional instrument in setting priorities for injury prevention. The importance of this instrument is increasingly being recognized by health policy makers. The objective of this study was to develop a model which continuously monitors the direct medical costs of injuries in The Netherlands. This model should provide information on the direct medical costs of injuries at any time and for any selection of injury categories. It is an incidence-based model according to the ‘bottom up’ principle. Homogeneous patient groupings with respect to health care use are defined. The groupings are based on existing classifications from the literature and the experience of medical experts, and are defined by means of seven criteria: nature of care provided, body region of the injury, type of injury, severity of injury, age, complications, and sex of the patient. Several cost elements are distinguished (e.g., general practitioner help, hospital care, nursing home care). For each cost element, relevant patient groupings are determined. The new Dutch Injury Surveillance System (LIS) for injuries treated in an A&E department is an important source for incidence data. This article presents the design of the model as adopted by the Working Group on the Costs of Injuries of the European Consumer Safety Association (ECOSA).     

Morbidity and mortality from road traffic crashes in children in Metro West,City of Cape Town – 2014

The road traffic crash injury burden significantly impacts the lives of South African children. This study aimed to assess the fatal and non-fatal pattern of road traffic crash injury of children under 13 years old from Metro West, City of Cape Town, from 1 January until 31 December 2014. The data were stratified by age, sex and mechanism of road traffic crash. The overall mortality rate was 8.7 per 100 000 population and pedestrians contributed the most to this burden (72.5%). There were more male children involved in a road traffic crash (p?=?0.0001). The greatest proportion of fatal and non-fatal road traffic crash injuries was observed in children aged 5–9 years. Fractures contributed to the greatest rate of years lived with disability (3.0 years of life lived with disability per 100 000). Our study found that the burden of road traffic crashes primarily affects male pedestrians aged 5–9 years old.     

The Routes of Moral Development and the Impact of Exposure to the Milgram Obedience Study

This article examines how business students route themselves through the process of cognitive moral development (CMD) to arrive at a more autonomous level of CMD when there is an impetus to do so. In this study, two groups were given Rest’s Defining Issues Test; half the test 1 week and half three weeks later. In between, one group viewed a film of Milgram’s obedience study as a stimulus towards a more autonomous level of CMD. The results of the analysis indicate that viewing the Milgram study produced a positive response regarding subjects’ level of autonomous CMD. However, the response was not uniform across the subject pool. Females showed a greater consistent significant positive response to viewing Milgram while male subjects varied their response contingent upon their functional area of study. While subjects’ functional area of study alone made little difference in the results, when taken in conjunction with gender, significant differences were found between groups. Thus, researchers should take care when investigating differences between subjects’ area of study since gender differences may be present even within an apparently homogenous population-like business students. Marnie Young is currently completing her Masters in Counselling Psychology at the Adler School of Professional Psychology in Vancouver, BC, Canada. This article was developed from Her Honours BA thesis from Laurentian University where she graduated Cum Laude in 2000. She has presented research papers at the Administrative Sciences Association of Canada and the Academy of Management. Her paper presented to the Administrative Sciences Association of Canada in 2000 won Honourable Mention in the Business Education Division. Jerry Paul Sheppard is an Associate Professor Strategic Management at Simon Fraser University, Burnaby, BC, Canada. His research focuses primarily on organizational decline, turnaround, survival and failure. His PhD dissertation from the University of Washington in 1989 won the Strategic Management Society Best Dissertation Award. He has published Journal articles in the Journal of Management, Long Range Planning and Social Science Research. His most recent work includes Strategic Management: Competitiveness & Globalization, 2nd Canadian Edition, with Hitt, Ireland, Hoskisson, and Rowe.     

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.