Surveillance of interpersonal violence in Kingston,Jamaica: an evaluation

Injuries are among the leading causes of death in Jamaica. Homicide rates have been sharply increasing since 1991. In 1997, the rate of homicide (45/100 000) in Jamaica was over five times the US rate in 1997 (7.9/100 000). In response to this problem and the alarming increase in non-fatal assaultive injuries, the Jamaican Ministry of Health together with the CDC established a Violence-Related Injury Surveillance System (VRISS) using patient registration data from Kingston Public Hospital. The VRISS was evaluated for usefulness, and for system attributes: system acceptability, simplicity, flexibility, sensitivity, and predictive value positive (PVP). System-identified cases were compared with clinical records and data from direct patient interviews. The surveillance system was flexible, acceptable to clinical staff and Ministry officials, and moderately sensitive, detecting 62% to 69% of violent injuries identified from clinical records and a patient survey. The system's predictive value positive was high, with 86% of potential cases confirmed as actual cases. Although adequate, system sensitivity was reduced by incomplete or no registration of patients during periods of staff shortage. In conclusion, despite some logistic shortcomings, the system appeared promising for collecting limited information on non-fatal interpersonal violent injuries. With modification and expansion, the system may be capable of collecting unintentional-injury data also.     

Business justice: Transactions,resources, and organisations

This paper outlines an egalitarian theory of business justice, and indicates its requirements in respect of the central business institutions of transactions, resources and organisations.David Wood, is Senior Lecturer in Law, and formerly Senior Research Fellow, Centre for Philosophy and Public Issues, University of Melbourne. He has published widely in legal and philosophical journals. He is assistant to the general editor, Nijhoff International Philosophy Series.     

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.     

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.     

Bicycle-related injuries: Injury,hazard, and risk patterns

Abstract

This paper provides the results of a U.S. Consumer Product Safety Commission (CPSC) study to determine the circumstances involved in bicycle-related injuries treated in U.S. hospital emergency rooms. It also includes information from a CPSC exposure survey of the U.S. population of bicycle users and their patterns of bicycle and helmet use. Together, these data were used to identify and evaluate risk factors currently associated with bicycle use in the United States

Risk models identified factors specifically associated with injuries to children and to adults. Children were at particular risk of injury, and appeared to be especially vulnerable to head injury. In addition, the risk of injury for children was significantly increased when riding in non-daylight conditions. For both adults and children, there was a higher risk of injury on streets than in such areas as bike paths or unpaved surfaces. While some problems associated with bicycle assembly, operation, and maintenance were observed, the data did not suggest that any mechanical remedy is likely to reduce injuries substantially.     

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.     

Team and organizational resources, strategic orientations, and firm performance in a transitional economy

Firms in transitional economies are learning to develop strategies to exploit new market opportunities though bounded by their lack of market experience and resources as well as institutional and cultural heritage. This paper examines the managerial orientations of top managers in the transitional economy of China by focusing on a firm's team and organizational resources. Specifically, the following antecedents motivate a firm to put more emphases on strategic orientations: the firm has an effective top management team, strong managerial competences, and when the firm has ample endowment of slack resources, social network, and support from the institutional environment. Empirical results support that team orientation, managerial competence, social network, and local institutional support are instrumental in developing market-focused strategic orientations. In addition, strategic orientations with heavy emphases on overall low costs and product innovation relate to higher firm performance.     

Paediatric head injuries treated in a children's emergency department from Cluj-Napoca,Romania

The aim of the study was to describe paediatric head injuries and identify factors that led to advanced care. Incident cases of head injuries that sought care from December 2008 to October 2010 at Children's Emergency Hospital Cluj-Napoca were evaluated. The main outcome was transfer or admission to advanced care. From a total of 3053 children treated for an injury, 1541 (50.4%) presented with head injury. A total of 960 (62.3%) of the children with a head injury required advanced care treatment. Young children were more likely to suffer a head injury than older children, but a higher proportion of older children required advanced care (70.3%). Children who suffered a head injury as a consequence of road traffic were almost five times more likely to require advanced care (OR: 4.97; 3.09-8.06) than being released. Our results suggest that data on injuries provide evidence-based information on the nature of injuries children are prone to, and what activity, type, and mechanism of injury impact Romanian children.     

Competitiveness, resources, and capabilities: empirical evidence from retail banking

This research aims to identify and measure bank employee perceptions of the determinants of competitiveness in terms of resources, skills, and capabilities within the retail banking sector. All the 40 branches of a leading Portuguese bank—the Caixa Geral de Depósitos—operating in two Portuguese districts were surveyed. Our results show that bank competitiveness differs according to performance evaluation, human resource (HR) planning, the system of incentives, and managerial motivation. They also demonstrate that human capital is a source of success in the business of banks, which relies heavily on stable and enduring relationships with customers. The study also provides recommendations for retail bank managers seeking to refine their HR strategies as a means of improving their competitiveness.     

Entrepreneurial strategy making,resources, and firm performance: evidence from China

This article builds a model to answer a critical but unsolved research question: What are the resources and/or the resource portfolio firms need to achieve the performance implications of entrepreneurial strategy making (ESM)? Based on a survey of Chinese firms, we find that ESM has a significant positive influence on firm performance. In addition, to accomplish the performance implications of ESM, firms need both flexible employed resources and unabsorbed slack, while just one of them does not work. Thus, a resource portfolio composed of high flexible employed resources and unabsorbed slack is the appropriate one to achieve the value of ESM.     

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.     

Knowledge based resources, property based resources and supplier bargaining power in Hollywood motion picture projects

Supplier bargaining power is a factor that must be considered in resource based theories of dynamic capability. As competitors develop capabilities for dynamically changing resource configurations, they become more reliant on suppliers and allies. Because different types of supplier will have more or less bargaining power, some resource configurations will be more attractive to buyers. Hypotheses are developed and tested using data on star power, intellectual property, knowledge based resource quality, costs and revenues for 278 motion pictures released in the United States in 2000 and 2001. Suppliers appear to fully appropriate returns to knowledge and property based services, while buyers benefit from control of intellectual property and from the combination of intellectual property and talent behind the camera.     

Equipment-related injuries in agriculture: an international perspective

Injuries related to agricultural equipment are a significant cause of morbidity and mortality, in both high-income and low-income countries. Tractors are most often associated with severe injuries and fatalities. All age groups sustain injuries. Injuries to children are also prevalent because the sites of agricultural work overlap homes in rural areas. In the majority of papers reviewed, preventive methods are mostly targeted at behaviour modification and effective medical facilities, whereas only a few authors have highlighted design changes and passive measures for injury control. The effectiveness of suggested interventions is not discussed in the majority of papers except those related to roll-over protection structures, fodder cutting machines and thresher safety devices.     

Integrating nonmarket and market resources,strategy and performance in Chinese enterprises: a review of the field and a resource-based empirical study

The resource-based view (RBV) regards strategy as deploying resources to obtain a competitive advantage. This article adopts such a RBV, by a simultaneous consideration of nonmarket and market factors, and then an empirical analysis of the relationships between such nonmarket and market resources, strategies and performance, focusing specifically on Chinese enterprises. The results test hypotheses related to the integrated strategy and RBV of the firm on linkages of nonmarket and market components. Combining those two views, this study reveals that there is a high and positive correlation between nonmarket and market strategies, while nonmarket strategy has a positive indirect effect on market performance via nonmarket performance. These findings suggest that the RBV is an appropriate theory for addressing the shortcomings in integrated strategy research.     

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.     

Epidemiology of unintentional child injuries in the South-East Asia Region: a systematic review

All the 11 members of the South-East Asia Region (SEAR) of the World Health Organization are categorised as low- and middle-income countries. This region has over a quarter of the world's total population but comprises about one-third of the world's unintentional injury-related deaths. There is a paucity of good-quality mortality and morbidity data from most of these countries. This is the first systematic review of community-based surveys on child injuries that summarises evidence from child injury studies from the SEAR countries. The included papers reported varying estimates of overall non-fatal unintentional injury rates across the countries, from 15/1000 children in Thailand to as high as 342/1000 children in India. The fatal injury rates were also found to be varying. This review revealed a need for strengthening child injury research using standard methodologies across the region and for promoting the dissemination of the results.