The Functional Capacity Index, second revision: morbidity in the first year post injury

As the field of injury outcomes measurement has moved beyond counting deaths and injuries, the need for instruments to measure long-term outcomes has increased. Early validation efforts indicated that the Functional Capacity Index (pFCI12) was a promising tool for predicting functional loss 12 months post trauma, but that the predictive validity for lower extremity fractures was low. The pFCI12 was recently revised in conjunction with the 2005 revision of the Abbreviated Injury Scale (AIS). This preliminary study was undertaken to assess the performance of the revised pFCI12 in predicting outcomes for patients with lower extremity trauma. This case review study used the Crash Injury Research and Engineering Research (CIREN) database which includes AIS codes, extensive clinical data and 3- and 12-month outcomes. Generally predicted functional loss at 12 months was greater with the pFCI12 (AIS 2005) than with the original FCI based on AIS 1990. All patients whose pFCI12 scores predicted functional loss experienced some morbidity at 1 year. The pFCI12 appears to provide improved predictions of functional outcome 12-months post-trauma for persons experiencing lower extremity trauma.     

An investigation on knowledge-attitude-practice about injury and the related factors among school children's parents in Jinan, China

The aim of this study was to investigate the knowledge-attitude-practice (KAP) and their related factors on injury prevention and safety promotion among children's parents in the city area, in order to provide scientific data for the development of Safe School in mainland China. A total of 3617 subjects were investigated in Jinan with the help of a self-administered questionnaire which included parental demographic characteristics and 40 questions related to KAP about injury prevention and safety promotion. Responses to each question included only one correct answer. A score of 1 was given if the participant answered correctly, otherwise the score was 0. Therefore, the total KAP score was 40 if all the 40 questions were answered correctly by one respondent. The total KAP scores were classified into two categories for which the cutoff value was the mean of the total KAP scores. The results showed that the KAP scores ranged from 13 to 39, with an average of 30.79?±?3.54. Higher KAP scores were statistically associated with mothers (odds ratio [OR]?=?1.79) and higher education level (OR?=?1.34). It was concluded that parental KAP about injury prevention and safety promotion was unsatisfactory, and health education on KAP about injury prevention and safety promotion for parents, especially among fathers and parents with low education levels, should be strengthened further by Safe School programmes.     

Complicated head trauma from machete wounds: the experience from a tertiary referral hospital in Jamaica

There have been limited reports on machete wounds to the cranium. This study was carried out to document the injury profile in a series of patients who have sustained cranial injuries from machete wounds in this setting. Between 1 January 1998 and 1 January 2008, demographic and clinical data were retrospectively collected from all patients treated with complicated head injuries from machete wounds with at least one of the following clinical or radiological features: a recorded Glasgow Coma Score < 8 at any point during admission; compound skull fractures; protruding brain matter; cerebrospinal fluid (CSF) leaks; intra-cranial bleeding; parenchymal contusions; lacerations and/or oedema. The data were analysed using the SPSS version 12.0. Of the 40 patients with complex injuries to the cranium, there was a 6:1 male preponderance with a mean age of 32.5 ± 13.7 years (Mean ± SD). The injuries included open skull fractures in all the 40 (100%) patients, depressed skull fractures in 20 (50%) patients, CSF leaks in 4 (10%) patients, protruding brain matter in 4 (10%) patients, cerebral contusions in 3 (7.5%) patients and extra cranial injuries in 16 (40%) patients. Tetanus prophylaxis and intravenous antibiotics were administered to all patients, and phenytoin was required in 16 (40%) cases. There were 37 (92%) patients requiring operative intervention at a mean of 10.4 h after presentation (SD ± 18.1; Median 6). The operative procedures included elevation of depressed fractures in 20 (54.1%) patients, dural repair in 10 (27.0%) patients and intra-cranial debridement in 7 (18.9%) patients. There were three deaths (7.5%), and seizures were recorded in 5 (12.5%) cases with no reports of infectious morbidity. Eighty percent of patients had a normal Glasgow outcome score on discharge. Complicated machete head trauma is uncommon at this health care facility in Jamaica. We achieved a satisfactory outcome with aggressive management consisting of prompt assessment of the extent of injury, appropriate antibiotics, anticonvulsants for those with seizures or cortical injury and early operation to decrease the risk of complications.     

Feasibility of routine collection of injured worker occupational information in hospital emergency departments

The aim of this study was to examine injury events and risk-factors among Swedish adult eventing athletes. A cross-sectional study design with retrospective recording of 1-year sports-specific exposure and injury data was used. The invited study population consisted of all members of the Swedish Equestrian Federation with eventing as their primary discipline (n = 513). The participation rate was 70.0%. The total 1-year injury prevalence was 26.6%; the specific 1-year prevalence of traumatic injury was 19.3% and of overuse injury 10.9%. The incidence of traumatic injury events was 0.54 injury events/1000 eventing hours (95% confidence interval (CI), 0.35–0.73 injury events/1000 eventing hours) for novices and 0.35 injury events/1000 eventing hours for qualified riders (95% CI, 0.21–0.49 injury events/1000 eventing hours). A total of 27.9% of the traumatic injury events led to severe injuries (causing more than 3 weeks absence from riding). Attitude to risk-taking was the only factor predicting an athlete becoming injured (p = 0.023), and qualification level was the only risk factor for additional injuries among injured riders (p = 0.003). Our results suggest that injury prevention programs in eventing should also give attention to overuse injuries and that care should be taken when eventing athletes are licensed into higher qualification groups.     

Risk factors for injury in community-level football: a cohort study

We investigated the independent effect of commonly postulated risk factors on injury incidence in amateur football (soccer), using a prospective cohort design with follow-up over two seasons. A total of 1702 male and female players aged 13 years or older contributed information on 21,797 player-matches. Confirmed, were the effect of male vs. female sex (injury rate ratios (IRR) = 0.81, 95% confidence interval (CI): 0.67–0.97), older age (increasing IRR gradient), New Zealand European ethnicity (IRR = 0.87, 95% CI: 0.74–1.01), being taller (180–189 cm: IRR = 1.32, 95% CI: 1.06–1.63), previous injury (IRR = 1.32, 95% CI: 1.12–1.57), playing against medical advice (IRR = 1.24, 95% CI: 1.03–1.49), playing while recovering from injury (IRR = 1.40, 95% CI: 1.20–1.49), history of cigarette smoking (IRR = 1.27, 95% CI: 1.00–1.61) and time of season (IRR = 0.97, 95% CI: 0.96–0.98). Female, adult, non-European and taller players could be paid particular attention in injury prevention programmes. The need for effective injury management is reinforced. Adding physical conditioning to pre-season training may be required.     

Disability users’ evaluation of the web accessibility of SNS

Social network service (SNS) is an effective communication tool for the community of disabled people. However, there is a general paucity of research on web accessibility of SNSs. This study investigates web accessibility of four SNSs that are most popular among disabled people: Facebook, Twitter, Me2day, and Yozm. Eight disabled individuals were selected according to the type of disability: two with total blindness, two with low vision, two with brain lesions, and two with an upper extremity disability. The subjects were asked to perform four navigation-related tasks and ten general tasks for each SNS. The success rate of their performances and user satisfaction levels were then measured. The four SNSs, on average, attained a task success rate of 73 % and a user satisfaction score of 3.1 points (max. = 5), indicating that the disabled participants found the websites generally inconvenient. As a pioneering evaluative study of the web accessibility of major SNS sites for the disabled, this research contributes to both theory and practice.     

Ergonomic Assessment of Musculoskeletal Discomfort Among Commissary Foodservice Workers in Taiwan

Abstract

This study was conducted to investigate the prevalence rate and potential risk factors associated with work-related musculoskeletal discomfort among commissary foodservice workers in Taiwan. Many workers reported numb or sore discomfort in their shoulders (41.1%), hands/wrists (38.2%), and lower backs (40.1%). But the three highest discomfort scores were for the elbow 3.00 (±1.05), finger/wrist 2.74 (±1.04), and upper back 2.74 (±0.92) according to the 5-point level scores. Several tasks had significant correlations: packing lunch box with forearm discomfort (odds ratio; OR = 1.9) and ankle/feet discomfort (OR = 2.5), moving object with forearm discomfort (OR = 2.6), and pre-preparing with lower back discomfort (OR = 2.0). The RULA (Rapid Upper-Limb Assessment) was used to evaluate working postures. The most frequent upper arm extension (flexion) was 20-45? or more, and the range for the lower arm was less than 60? or more than 100? of flexion. The participants' heads were in extension and their trunks had the highest degree of flexion. Moreover, their legs and feet were not balanced properly. RULA was determined from video recordings and presented as a useful technique. Results indicated that all four jobs (pre-prep/bussers, preparation/cooks and chefs, utility/dish washers, and service/packers) had frequent extension/flexion postures and posted high grand total risk scores (4.93-5.69).     

The impact of emotional appeal and the media context on the effectiveness of commercials for not-for-profit and for-profit brands

This study investigates the impact of emotions, both ad- and context-evoked, on the effectiveness of commercials for not-for-profit vs. for-profit brands. Two types of emotional impact are taken into account: firstly, the emotional appeal of the commercial itself and secondly, the emotion evoked by the context in which the commercial is embedded. Effectiveness is made operational by both rational (recall, recognition) and emotional measures (likeability, understanding of the ad and reduced intention to switch the ad). The main research uses a 2 × 2 between subjects design where the context (warm vs. sad film fragment) and the type of commercial (warm vs. sad) were manipulated for not-for-profit and for-profit brands. The appropriate stimuli were identified in a preliminary study. The results indicate that, overall, sadness as an execution approach works better for commercials. This is in particular the case for the rational impact measures of the for-profit brands. For the not-for-profit brands, the emotional measures have significantly higher scores. Moreover, a context-evoking sadness proves to be the most responsive for the for-profit brands.     

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.     

Injury rates and risk-factors associated with eventing: a total cohort study of injury events among adult Swedish eventing athletes

The aim of this study was to examine injury events and risk-factors among Swedish adult eventing athletes. A cross-sectional study design with retrospective recording of 1-year sports-specific exposure and injury data was used. The invited study population consisted of all members of the Swedish Equestrian Federation with eventing as their primary discipline (n = 513). The participation rate was 70.0%. The total 1-year injury prevalence was 26.6%; the specific 1-year prevalence of traumatic injury was 19.3% and of overuse injury 10.9%. The incidence of traumatic injury events was 0.54 injury events/1000 eventing hours (95% confidence interval (CI), 0.35-0.73 injury events/1000 eventing hours) for novices and 0.35 injury events/1000 eventing hours for qualified riders (95% CI, 0.21-0.49 injury events/1000 eventing hours). A total of 27.9% of the traumatic injury events led to severe injuries (causing more than 3 weeks absence from riding). Attitude to risk-taking was the only factor predicting an athlete becoming injured (p = 0.023), and qualification level was the only risk factor for additional injuries among injured riders (p = 0.003). Our results suggest that injury prevention programs in eventing should also give attention to overuse injuries and that care should be taken when eventing athletes are licensed into higher qualification groups.     

Costs of unintentional injuries among children in an urban slum community in Kampala city,Uganda

Abstract

Unintentional injuries cause deaths, disabilities, productivity and financial losses and disproportionately affect children in low-income settings yet their cost remains under studied. This study determined the household out-of-pocket expenditure and missed school attendance due to unintentional childhood injuries in a Ugandan slum. We used a cross-sectional household survey design. Data were collected on occurrence and associated costs of unintentional injuries during a one-year period from July 2014 to June 2015. A total of 706 (44.7%) children who had suffered from injuries were reported in the one year period. More male children (N?=?415, 58.7%) suffered injuries than females (N?=?291, 41.2%). The average out-of-pocket expenditure on treating an injury was US $24.1 [standard deviation (SD)?=?±$62.8] and mean school days lost were 25 days (SD?=?±51.8). Road traffic injuries (RTIs) resulted in higher costs [mean difference was US $51.1 (95% CI: $11.4–$90.8)] compared to injuries that, for example, occurred at school. In a Ugandan slum community, unintentional childhood injuries resulted in high out-of-pocket expenditures and missed school attendance. The costs varied widely depending on external causes of the injury. These findings highlight the need to invest in population level injury prevention interventions to reduce injury costs by households.     

Injury among migrant workers in Changning district,Shanghai, China

The objective of this study was to characterise the injury epidemic and injury prevention needs of migrant workers in Shanghai. Cluster random sampling was applied in selecting subjects in migrant gathering areas, and face-to-face interview survey was conducted in this study. In this survey, 1256 migrant workers were included, among which the injury incidence in last one year was 38.3%. The first four injuries were incised and penetrating injury (9.5%), falls (7.2%), traffic injury (6.3%) and burns (5.3%). The injury incidence of male workers was significantly higher than that of female workers (χ² = 22.7, P < 0.01). Electricians, safeguards and construction workers were at the highest risk of getting injured. About 60.7% of injury episodes happened at a residence. The longest period of absence from work was up to 3 months due to falls, while the highest medical expense was near 9999 CNY ($1464.2) caused by traffic injury. About 62.9% of migrant workers need services on injury prevention. It is concluded that compared with urban registered residents, migrant workers have significantly higher incidence of injury in Shanghai. Injury prevention services are in urgent demand among the migrant workers.     

Exceeding the speed limit: prevalence and determinants in Iran

Speeding is one of the most common risk behaviours associated with crashes causing signficant injury. The objective of this study is to explore the prevalence and determinants of speeding on a road between Tehran and Hamadan, Iran. In a cross-sectional study in 2009, stretches of the road were studied including three groups of posted speed limits: < 50 km/h, 50–100 km/h and > 100 km/h. Each stretch was evaluated both in daylight and dark. Randomly identified driver's speed was checked by a handheld speed camera and then the driver was invited to participate in a survey. Statistical analysis was performed using Chi-Square, crude and adjusted odds ratio, 95% confidence interval and multiple logistic regression models. Overall, 52.8% of the drivers were travelling more than 10 km/h above the posted limit. Where limits were < 50 km/h, 74.6% of drivers were speeding. This declined to 46.9% for sections with limits between 50 and 100 km/h and to 36.9% for sections posted more than 100 km/h. Finally, more than half the drivers were observed to be speeding. Driving more than the posted limit was far more likely on the areas with the lowest posted speed limits, personal passenger vehicles, modern vehicles not using seat belts, and male drivers.     

Childhood and adolescent injuries in elementary schools in north-western Uganda: extent,risk and associated factors

Childhood injuries remain understudied in Uganda. The objective of this study was to determine the extent, nature and determinants of school-related childhood injury risk in north-western Uganda. A cohort of 1000 grade fives from 13 elementary schools was followed-up for one term. Survival and multi-level modelling techniques compared the risk rates across gender, schools and locations. Childhood injuries are common in north-western Uganda. Most of them occur during travel, breaks, practical classes and gardening, while walking, playing, learning and digging. Most injuries result from collisions with objects, sports and falls. Two-thirds of children receive first aid and hospital care. Times to injury were 72.1 and 192.9 person days (p = 0.0000). Gender differences in time to event were significant (p = 0.0091). Girls had better survival rates: cumulative prevalence of childhood injury was 36.1%; with significant gender differences (p = 0.007). Injury rate was 12.3/1000 person days, with a hazard ratio of 1.4. Compared to girls, boys had a 37% higher injury rate (p = 0.004). Rates varied among schools. Associated factors include sex and school. Rural–urban location and school differences do influence childhood injury risk. Childhood injuries are common: the risk is high, gender- and school-specific. Determinants include gender and school. Location and school contexts influence injury risk.     

Sponsorship programmes and corruption in sport: management responses to a growing threat

Abstract

Sponsorship programmes are increasingly being exposed to the threat of corruption in sport. Several recent notable cases of corruption have exposed sponsors and their investments to significant perceived pressures including negative consumer associations with athletes, teams and officials that have been found guilty of engaging in corrupt activity. How sponsors respond to such instances of corruption in sport forms the basis of this paper. Drawing from an analysis of corruption cases (n = 2089), the paper initially examines the nature of corruption in sport. Through interview data (n = 21), it subsequently identifies key factors that sponsors should take into consideration when deciding upon a course of action to mitigate any potential effects of corrupt activity by a sporting property they are associated with. Finally, the paper discusses those courses of action.     

Balance and agility training does not always decrease lower limb injury risks: a cluster-randomised controlled trial

The objective of this study was to examine the effects on lower limb injury rates of adding structured balance and agility exercises to the 80-day basic training programme of army recruits. A blocked (stratified), cluster-randomised controlled trial was employed, with one intervention group (IG) and one control group (CG), in which 732 male and 47 female army recruits from the Australian Army Recruit Training Centre participated through to analysis. The IG performed specified balance and agility exercises in addition to normal physical training. The incidence of lower limb injury during basic training was used to measure effect. Analysis, which adhered to recommendations for this type of trial, used a weighted paired t-test based on the empirical logistic transform of the crude event rates. The intervention had no statistically significant effect on lower limb injury incidence (RR = 1.25, 95% CI 0.97–1.53, 90% CI 1.04–1.47), on knee and ankle injury incidence (RR = 1.08, 95% CI 0.83–1.38), and on knee and ankle ligament injury incidence (RR = 0.98, 95% CI 0.64–1.47). We conclude that the intervention, implemented in this fashion, is possibly harmful, with our best estimate of effect being a 25% increase in lower limb injury incidence rates. This type of structured balance and agility training added to normal military recruit physical training did not significantly reduce lower limb, knee and ankle, or knee and ankle ligament injury rates. Caution needs to be used when adding elements to training programmes with the aim of reducing injury, as fatigue associated with the addition may actually raise injury risk.     

Injury prevention priority setting based on the National Injury Surveillance data in Korea

For the reduction of injury burden, injury prevention efforts are essential. However, financial, material and human resources are far from sufficient, and this situation necessitates setting priorities for effective injury prevention. Hence, the aim of this study is to prioritise 13 injury mechanisms for prevention of injury using four injury burden criteria. National death certificate, hospital discharge data and emergency data during 2004 were used. According to the 13 most frequent injury mechanisms (ICD-10), mortality priority score, years of potential life lost (YPLL) priority score, morbidity priority score and hospital charge priority score were calculated. Injury mechanisms which were ranked fourth or higher on at least three of the four criteria scores were arranged in rank orders. Traffic crashes ranked highest on all four of the priority criteria for injury prevention followed by fall and poisoning in second and third positions, respectively. Categorised by age groups, in 0-19 year olds, traffic crashes, suffocation and drowning; in 20-59 years, traffic crashes, suffocation and poisoning; and in 60 and over, traffic crashes and fall were shown to be significant injury prevention priority in rank orders. Injury prevention priorities identified from this study could be useful in strategically allocating limited resources and implementing more focused prevention policies in Korea.     

Injury prevention priority setting based on the National Injury Surveillance data in Korea

For the reduction of injury burden, injury prevention efforts are essential. However, financial, material and human resources are far from sufficient, and this situation necessitates setting priorities for effective injury prevention. Hence, the aim of this study is to prioritise 13 injury mechanisms for prevention of injury using four injury burden criteria. National death certificate, hospital discharge data and emergency data during 2004 were used. According to the 13 most frequent injury mechanisms (ICD-10), mortality priority score, years of potential life lost (YPLL) priority score, morbidity priority score and hospital charge priority score were calculated. Injury mechanisms which were ranked fourth or higher on at least three of the four criteria scores were arranged in rank orders. Traffic crashes ranked highest on all four of the priority criteria for injury prevention followed by fall and poisoning in second and third positions, respectively. Categorised by age groups, in 0–19 year olds, traffic crashes, suffocation and drowning; in 20–59 years, traffic crashes, suffocation and poisoning; and in 60 and over, traffic crashes and fall were shown to be significant injury prevention priority in rank orders. Injury prevention priorities identified from this study could be useful in strategically allocating limited resources and implementing more focused prevention policies in Korea.     

Effect of caregiver feeding behaviours on child nutritional status in rural Ghana

A six‐month observational study involving 100 mothers with infants between the ages of 6 and 12 months was conducted in the Manya Krobo district of Ghana. The objective was to assess the role of caregiver feeding behaviours on child nutritional status using a modified positive deviance approach. Each child was in the study for 6 months, during which they were observed at home once a month. On each visit, data were collected on the child anthropometry, child meal frequency, diet diversity, responsiveness of caregiver during feeding, child’s appetite and feeding atmosphere as well as caregiver hygienic practices related to feeding. Using weight‐for‐age (WAZ) and length‐for‐age (LAZ) scores, the children were classified as positive or negative deviant children. The study revealed significant differences between the two groups of children in terms of caregiver feeding behaviours. Positive deviant children had significantly higher meal frequencies (3.1 ± 0.4 vs. 2.4 ± 0.6, P = 0.001), diet diversity scores (6.3 ± 0.6 vs. 3.7 ± 1.1, P = 0.001), were fed under better hygienic conditions (7.2 ± 0.9 vs. 4.2 ± 1.1, P = 0.001) and were much more interested in food during feeding (85.8% vs. 59.3%). Caregiver responsiveness during feeding was also significantly higher among the positive deviant group (6.5 ± 0.8 vs. 4.5 ± 0.9, P = 0.001). This study has demonstrated the tremendous effect of caregiver feeding behaviours on child nutritional outcomes and provides a scientific basis for introducing care during feeding as a component of intervention to improve child nutritional status in Ghana.     

Predictors of return to work and duration of absence following work-related hand injury

The aims of the study were to explore the situation and the potential determinants of return-to-work (RTW) and the absence duration following work-related hand injury, and to provide evidence for the future intervention strategy of improving RTW. A prospective cohort of workers with work-related hand injury from three selected hospitals in East China was followed up on the outcomes of RTW up to 8 months after discharge. Demographic and clinical data were collected during admission; economic factors, psychological factors and RTW outcomes were, respectively, investigated using a structured questionnaire via phone call after discharge from the hospitals in 0.5 month, 2 months, 4 months and 8 months. Univariate analysis and Cox regression model were used to examine the associations between potential determinants and outcomes of the RTW. Out of the 246 cases, 192 (78.1%) eventually returned to work with the median duration of the absence of 44.0 days during the 8-month follow-up. Factors from demographic, clinical, economic and psychological domains affected RTW in the univariate analyses. Receiving timely treatment at outpatient clinics, less serious injury, no tendon trauma and no skin loss were found to be significantly beneficial to RTW, while workers with the decreased monthly salary during absence and lower pre-injury salary were likely to take longer sick leave. Most of the workers successfully achieved RTW after work-related hand injury. Proper clinical treatment and rehabilitation, as well as economic and social support seem to have played vital roles in prompting RTW that should be prioritised for the intervention strategy.