The pattern and predictors of intentionally inflicted injuries on Greek adults; data from an Emergency Injury Surveillance System (EDISS)

Background Intentional injuries due to violence are both a social and a public health problem in most societies. This study assesses the patterns and some of the sociodemographic determinants of violence-related injuries among Greek adults. Methods Data recorded by the Emergency Department Injury Surveillance System (EDISS) during the two-year period 1996-1997 were used. This database relies on all age injury data collected in the emergency departments of three sentinel hospitals, covering both urban and rural population areas. Results Among 52026 recorded injuries, 1322 (3%) were violence related, excluding self-inflicted injuries, while the majority of injuries (28269) were attributed to home and leisure accidents. Weapons of any type were used only in 5% of violence-related injuries. In comparison to home and leisure injuries, the intentionally inflicted injuries occurred more frequently among men, among those 25-54 years old, and were particularly common among migrants and during late night and early morning hours. Violence-related injuries frequently occur in pubs, restaurants, cafeterias and other places of entertainment. However, 52% of violence-related injuries among women occurred at home. Intentional injuries were generally more severe than unintentional ones. Conclusions We conclude that violence is not a negligible public health problem in the Greek population, but is considerably less serious than in most other developed countries. In particular, firearms-related injuries represent a very small fraction of the generally low incidence of violence-related injuries in this Mediterranean country.     

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.     

Product design and tort law: Safety implications of increasing similarity in civil liability and regulatory standards

This article addresses the impact of changes in design defect tort law on safety in the European Union and the United States, and draws two conclusions bearing significant product safety implications. First, tort law’s approach to design defectiveness is developing more cohesion. Although important differences in jurisdictional approaches remain, the differences appear to be diminishing rather than growing. In both the United States and the European Union, courts are increasingly relying upon a risk/utility balancing test to determine whether to impose civil liability for allegedly defective product designs. Second, the direction in which tort law is evolving is bringing it closer to defectiveness tests typically employed by government regulatory agencies in Europe and the United States. Civil liability standards are increasingly similar to regulatory standards used in determining whether a product should be allowed on the market at all. This trend toward greater cohesion in tort standards, and tort law’s increasing similarity to regulatory standards, has both positive and negative implications for safety. On the whole, the trend is likely desirable – it should encourage efficient products that are closer to an optional blend of safety and utility.     

Safety evaluation model of urban cross-river tunnel based on driving simulation

Currently, Shanghai urban cross-river tunnels have three principal characteristics: increased traffic, a high accident rate and rapidly developing construction. Because of their complex geographic and hydrological characteristics, the alignment conditions in urban cross-river tunnels are more complicated than in highway tunnels, so a safety evaluation of urban cross-river tunnels is necessary to suggest follow-up construction and changes in operational management. A driving risk index (DRI) for urban cross-river tunnels was proposed in this study. An index system was also constructed, combining eight factors derived from the output of a driving simulator regarding three aspects of risk due to following, lateral accidents and driver workload. Analytic hierarchy process methods and expert marking and normalization processing were applied to construct a mathematical model for the DRI. The driving simulator was used to simulate 12 Shanghai urban cross-river tunnels and a relationship was obtained between the DRI for the tunnels and the corresponding accident rate (AR) via a regression analysis. The regression analysis results showed that the relationship between the DRI and the AR mapped to an exponential function with a high degree of fit. In the absence of detailed accident data, a safety evaluation model based on factors derived from a driving simulation can effectively assess the driving risk in urban cross-river tunnels constructed or in design.     

Road trauma perceptions and the potential influence of the media

The United Nations Decade of Action for Road Safety (2011–2020) recognises the urgency of addressing global road trauma. Road crashes and attempts to reduce risky driving, including public education campaigns, receive media attention in many countries. In Australia, road fatalities have declined significantly. However, the extent of awareness about this success and of fatalities overall is unclear. A survey of 833 Australian drivers revealed the majority of participants under-estimated fatalities. Unexpectedly, some under-estimates appear based on recollections of media reports. The findings suggest lack of awareness of the extent of road deaths and that, paradoxically, media reports might contribute to under-estimations. This represents a major public health challenge. Engaging community support for road safety, relative to other health/safety messages, may prove difficult if the extent of road trauma is misunderstood. Misperceptions about fatality levels may be a barrier to road users adopting safety precautions or supporting further road safety countermeasures.     

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.     

Socio-economic differentials in injury risk

The aim was to highlight the role of childcare products as causes for mild brain injury (concussion) in small children (0-4 years of age) and to determine the most dangerous products. By childcare products this report means the following items: child and baby furniture, nursing tables, baby walkers, toys, baby carriages, sport equipment for children, playground equipment and security equipment for children. The data were derived from the EHLASS (European Home and Leisure Accident Surveillance System) for 1998 and 1999 and covered a restricted population of Sweden (approximately 5 per cent). According to this register 182 mild brain injuries (concussions) were recorded following a fall, an accident or a blow to the head among children (0-4 years of age) during 1998 and 158 for 1999. Of those injuries, childcare products were the cause of the accident in 84 (46 per cent) and 76 (48 per cent) cases respectively for 1998 and 1999. The number of children admitted for hospital care was 68 (57/84) and 74 (56/76) per cent respectively. The home was the most common place of the accident and play and leisure activity were the most common activities. More than 50 per cent of these accidents took place during daytime. The product type that caused most accidents was nursery furniture and, in this category, the baby walker was the most dangerous. The product type that caused the second most frequent accidents was playground equipment.     

Road crash injuries and fatalities in Isfahan,Iran from March 2006 to March 2009

With rapid development of social economies, road traffic accidents have continued to increase, and have become the primary public hazard to humans. The main goal of the present study was to investigate road traffic crash (RTC) fatalities and injuries in the city of Isfahan, Iran. A sample of 150,940 accident cases was considered from Isfahan Police Safety Driving Department, involving drivers and passengers of all ages, and covering a 3-year period. The record linkage identified 24,608 drivers and passengers injured or died as a result of RTC in the city of Isfahan over the 3-year period. The finding of this study shows that the highest rate of RTC fatality was 40% and 58%, which comprises the male drivers and female passengers within the age classes 25–34 and 35–44, respectively. On average, there were one death every 3 days and every hour, someone was injured and taken to an emergency department for RTCs in the city of Isfahan. The highest men to women death and injured ratios were 4:1 and 2:1, respectively. The use of seat belt devices in our population was worrisome. The article ends with a number of recommended measures for the improvement of road safety.     

School safety assessment in Bengaluru and Kolar districts,India

Abstract

Ensuring optimum safety in schools to prevent injuries and promote safety of children is a mandate by the Constitution of India. However, there is limited evidence regarding safety and injury prevention in schools. This safety appraisal was conducted on a sample of 131 schools, selected by stratified random sampling in Bengaluru and Kolar districts in India. Trained investigators collected data using smart phone-assisted interview, observational methods and record review between 1 January and 31 March 2019. Safety was assessed across the domains of macro areas (policy, guidelines, committee, budget, coordination and training), physical infrastructure, road and transport safety, fire safety and first-aid services. Safety level (%) at each school was computed based on scores obtained in each domain. Overall safety level was at 50.8% of the assessment criteria and was relatively better in private schools (54%). Most schools scored less than 30% in domains of transport safety, fire safety and macro areas. Results highlight the need for implementing and augmenting safety measures in schools.     

Injuries in preschool children: the hypothetical protector effect of minor injuries and risk factors for minor and medically attended injuries

This study aimed to investigate the relationship between minor and medically attended injuries and to analyse the influence of child-related factors and family-related factors in injuries of preschool children. Individual interviews were conducted with 335 parents of 1- to 5-year-old children. Parents informed about the child and the family variables and reported the child's history of injuries in the last year. The frequencies of minor injuries and medically attended injuries were not correlated. The risk factors for both kinds of injuries include the number of siblings and the size of the family. Minor injuries were more frequent in older than in younger children. Medically attended injuries were more frequent in boys than in girls. The risk factors that influence minor and medically attended injuries are different, suggesting that the strategies to prevent and reduce injuries need to take that difference into consideration.     

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.     

Community safety promotion at local,regional, and national levels. Summary report from a workshop on local organizing and societal contributions with regard to the development of Safe Communities,held at the Third International Conference on Safe Communities,June 6-8, 1994, Harstad,Norway

Aim The aim of this review was to determine the extent to which the effectiveness of countermeasures for preventing alpine skiing injuries has been evaluated. Methods The methodology involved a critical review based on the available international literature and sports equipment standards, as well as consultation with experts in the field. Where possible, the review focused on controlled trials. Results Key injury countermeasures in skiing identified in this review include physical conditioning programmes, ski-bindings and their timely release, professional adjustment of ski-bindings and the use of mechanical testing devices for this, design of ski pole handles, helmets for children (and adults), ski patrollers, skier education, speed control on the slopes and safe lifting equipment. A tabular categorisation of the types of evidence for the effectiveness of injury countermeasures is presented. This demonstrates that the weight of evidence is generally based on a combination of data-based or biomechanical testing evidence and informed opinion/anecdotal evidence. There is minimal evidence based on controlled trials in the field. The most evaluated countermeasures are ski bindings and ski pole handles. Properly adjusted ski bindings have the potential for a 3.5-fold reduction in lower extremity injuries, particularly knee injuries. Ski pole handle design needs further innovation and attention. An immediate concern is the generally poorer standard of children’s equipment, ski bindings and their adjustment. Conclusion Skiing is a sport that is growing in popularity, but with a need for controlled trials of its injury prevention countermeasures. This review provides a basis for further action in injury prevention research, development and implementation.     

Sports injuries and injury-preventive behavior related to hockey and volleyball in the Netherlands

Abstract

In a survey of hockey and volleyball players, the number and nature of sports injuries, the percentage of players taking injury-preventive measures (warming up before and cooling down after playing and the use of gum-shields and knee caps) and the main reasons for taking these measures have been assessed by self-reports in a questionnaire. The questionnaire for hockey players was answered by 635 respondents, the questionnaire for volleyball players by 711 players. For both hockey players and volleyball players, an incidence of about 500 injuries per 1000 players per year was found. Almost all volleyball players warmed-up before the last game played and 86% wore knee caps. About 25% of all hockey- and volleyball players took part in cooling down after this game. A gum-shield was used by 25% of the hockeyplayers. Surprisingly, players who took part in cooling down appeared to have a higher number of injuries than those who did not.     

Keeping our children safe in motor vehicles: knowledge,attitudes and practice among parents in Kuwait regarding child car safety

Child safety restraints can reduce risk of death and decrease injury severity from road traffic crashes; however, knowledge about restraints and their use in Kuwait is limited. A cross-sectional, self-administered survey about child car safety was used among a convenience sample of parents of children aged 18 years or younger at five Kuwaiti university campuses. Of 552 respondents, over 44% have seated a child in the front seat and 41.5% have seated a child in their lap while driving. Few parents are aware of and fewer report using the appropriate child restraint; e.g., 36% of parents of infants recognised an infant seat and 26% reported using one. Over 70% reported wearing seat belts either “all of the time” (33%) or “most of the time” (41%). This new information about parents' knowledge and practice regarding child car seat use in Kuwait can inform interventions to prevent child occupant injury and death.     

Opportunities,threats and barriers to enacting mandatory child car restraint laws in Iran

Approximately one-third of Iranian children's deaths are caused by injuries. Of these, 36% result from road traffic injuries (RTIs). Both RTIs and fatalities could be reduced by using child car restraints (CCRs). Despite their demonstrated effectiveness, CCRs are not mandatory in Iran. This study was conducted to assess opportunities and barriers in enacting mandatory CCR laws in that country. Using mixed method research, a phenomenological approach was used to explore the experiences and perspectives of road safety stakeholders in regard to opportunities and threats in enacting mandatory CCR laws in Iran. The themes derived from group discussions were used to first develop a structured questionnaire, which was later distributed to and completed by study participants. The study analysis was conducted using scores and rankings from the responses to these questions. Twenty-eight stakeholders participated in the study. Most were male, aged 36.7 ± 5.6 (range 25–59). In terms of identifying the organization that should establish mandatory CCR laws, the Traffic Police Department achieved the highest score of 90 (range 0–100). The participants also thought that the Traffic Police department is responsible to monitor compliance and conduct follow-up investigations (score = 100). In regard to existing barriers in enacting CCR laws, the lack of positive Publicity by mass media and the lack of related laws received scores of 85 and 70, respectively. Enabling factors and opportunities included ‘positive regards or attitude of families towards their child's health,’ ‘officials’ commitment to support such laws' and ‘having adequate resources to raise community awareness of the importance of CCR use. These received scores of 83, 69 and 68, respectively. The results suggest that cooperation and collaboration among stakeholders including the Traffic Police, families and local communities are needed to maximize the likelihood of mandating CCR laws.     

Statistical considerations for the design,conduct and analysis of the efficacy of safe community interventions

In injury research, the use of community-level intervention trials is quite common. Often, it is the only practical method for assessing the efficacy of countermeasures or preventive interventions. ‘Safe Community’ is an intervention concept aimed at establishing community-level programs and policies to ensure the safety of inhabitants in a community. The methodological considerations in evaluating the efficacy of such interventions need to be well understood by injury researchers and policy makers. This paper presents various statistical issues that need to be considered in the design, conduct and analyses of community-level intervention trials. Only with an understanding of the statistical issues will such studies have the appropriate design, conduct and analysis, and thus be appropriately well-received, with the implication that they will indeed help to build safer communities.     

Burden,pattern and outcomes of road traffic injuries in a rural district of India

Road traffic injuries (RTIs) are a leading public health problem and the understanding of RTIs in rural India is limited. The present report documents the burden, pattern, characteristics and outcomes of RTIs in a rural district of India using combined data sources: police and hospital. RTIs contributed for 38% of fatal and 39% of non-fatal injuries with an annual mortality rate of 18.1/100,000 population/year. Young males were affected most and two-wheeler users and pedestrians were involved in 45% and 20% of fatal crashes, respectively. Nearly half (51%) of fatal RTIs occurred on national highways of the district; 46% died immediately at the site. Among those hospitalised, 20% were under the influence of alcohol while use of helmets and seat belts was <5%. Trauma care was deficient in the district leading to greater number of referrals. Road safety should be given high importance in rural India with a focus on safe roads, safe vehicles and safe people along with trauma care.     

Comparing the characteristics of snowboarders injured in a terrain park who present to the ski patrol,the emergency department or both

Ski patrol report forms are a common data source in ski/snowboard research, but it is unclear if those who only present to the emergency department (ED) are systematically different from those who see the ski patrol. To determine the proportion and characteristics of injured snowboarders who bypass the ski patrol before presenting to the ED, three groups of injured snowboarders were compared: presented to the ED only, ski patrol only and ski patrol and ED. Data were collected from ski patrol Accident Report Forms (ARFs), ED medical records and telephone interviews. There were 333 injured snowboarders (ED only: 34, ski patrol only: 107, both: 192). Ability, time of day, snow conditions or drugs/alcohol predicted ED only presentation. Concussions (RRR: 4.66; 95% CI: 1.83, 11.90), sprains/strains (RRR: 4.22; 95% CI: 1.87, 9.49), head/neck (RRR: 2.90; 95% CI: 1.48, 5.78), trunk (RRR: 4.17; 95% CI: 1.92, 9.09) or lower extremity (RRR: 3.65; 95% CI: 1.32, 10.07) injuries were significantly more likely to present to ski patrol only versus ski patrol and ED. In conclusion, snowboarders who presented to the ED only had similar injuries as those who presented to both.     

组织化管理、技术性贸易壁垒与农产品质量安全——基于浙江临海西兰花产业的分析

通过对浙江临海西兰花产业的调查与分析,研究了在面对技术性贸易壁垒冲击时农业块状经济内部不同主体的行为和反应。结果表明:企业在面临技术性贸易壁垒时感知最为明显,反应最为强烈,是合作推动的主体;农户有合作的意愿和倾向,但不同特征农户对合作态度有所分化;政府作用有待加强,实施机制有待完善。企业与农户构建的纵向合作模式能够有力地推动块状经济的组织化、标准化管理,较为有效地克服技术性贸易壁垒。     

农业产业化龙头企业财务风险成因及对策研究——基于山西省F企业的数据

在农业产业化进程中,农业产业化龙头企业逐步起到主导作用,是农业现代化的强大推动力量。国家为贯彻乡村振兴战略、促进农业发展,逐步发展成一批农业龙头企业。本文梳理归纳了农业产业化龙头企业财务风险受自然环境制约、市场环境影响及政策环境扶持,具有价格因素多样化、企业经营规范化、生产成本波动化的特点,总结农业龙头企业财务风险存在风险意识薄弱、融资渠道单一、专业人才缺乏等问题,通过对F企业财务风险案例进行分析、提供经验借鉴,并提出相应对策,以供参考。