Methodological issues in comparing injury incidence across countries

The primary objective was to describe the methodological challenges and devise solutions to compare injury incidence across countries. The research design was a mixed methods study, consisting of a consultation with an expert group and comparison of injury surveillance systems and data from ten European countries. A subset of fractures, selected radiologically verifiable fractures and a method of checking the national representativeness of sample emergency department data were devised and are proposed for further development. These methodological considerations and developments will be further refined and tested and should prove useful tools for those who need to compare injury incidence data across countries.     

Unintentional injury mortality trends in children and adolescents in Lithuania between 1971 and 2005

The objectives of the study were to estimate mortality rate trends due to road traffic, drowning and fire/burns in children aged 0-14 years and in adolescents aged 15-19 years in Lithuania between the years 1971-2005. The data were obtained from Statistics Lithuania and the Health Information Centre. Trends were estimated by linear and polynomial regression. The study revealed that the child and adolescent unintentional injury mortality rates show declining trends. For children, the significant decreasing trends of mortality rates due to road traffic, drowning and fire/burns were observed. For adolescents there were significant decreasing trends for drowning deaths, and insignificant decreasing tendencies for deaths from fire/burns. There was an insignificant increased road traffic mortality rate trend for adolescent girls. For the adolescent boys group and for boys and girls together from the beginning of the study period there were increasing trends, followed by declining trends. In the last years, the increase was observed again.     

The IMF and the countries of Eastern Europe

The countries of Eastern Europe need to raise considerable finance not only in order to improve their balances of payments but also to adjust the structure of their economies over the long term to changed internal and external conditions. The adjustment measures require capital, but the Eastern European countries have only limited scope to broaden their own capital base. What actual or potential significance does the international Monetary Fund have for overcoming the difficulties of the CMEA countries in question?     

Changes and trends in alcohol consumption patterns in Europe

Consumer behaviourists and consumer policy-makers are interested in the degree to which global convergence is occurring for various consumer behaviour dimensions, the extent to which the consumption patterns in different parts of the world are becoming similar and the extent to which these trends may be influenced and/or influence consumer policy. With increasing internationalization and cultural cross-fertilization, the industrialized societies of the world are converging in many ways. Shifts in alcohol consumption patterns in Europe over the past 50 years represent a case in point. As traditional cultural boundaries become blurred, consumer preferences for alcoholic beverages appear to be driven less by long-standing local and regional traditions and more by growing acceptance of a wider choice. The disparity in total alcohol consumption among the 15 countries studied has also decreased. Other powerful forces are likely to accelerate the pace of convergence in the future.     

Coming home to Europe: Greece and the Euro

The European Council’s recent decision that Greece is ready to join EMU at the beginning of 2001 raises a number of questions. How was Greece able to comply with the convergence criteria? What are the costs and benefits of its accession from both the Greek and the present EMU members’ perspectives? Is the current process of economic reform in Greece sustainable?     

Population and labour force growth and patterns in ASEAN countries

"The paper shows that the diverse labor dimensions prevailing in the ASEAN region can be attributed to changes in the structure of the society and economy in the course of recent economic development. It observes the considerable variety in the growth of the population and its effect on the labor force in the ASEAN region.... The paper details the similarity and diversity in the level and type of labor force participation rates. A common feature shared by ASEAN countries is a general pattern in the age-specific participation rate of men. In contrast, the women, aside from participating in the labor force at a much lower level than men at almost all ages, display diverse patterns of participation over the working age range. Lastly, the distribution of the labor force according to major industrial sectors in the six ASEAN countries is presented...."     

The incidence of home accidents is going down in Belgium

The objective of the present study was to estimate the incidence of home accidents in Belgium in 2002 and to compare them with the results of 1996. The Belgian network of general practitioners (GPs) is a national network of GPs who collect and report data on selected conditions, including home accidents. The data about home accidents were recorded by 181 GPs in 1996 and by 150 GPs in 2002. The standardized incidence of home accidents decreased from 2935 per 100 000 inhabitants in 1996 (95% CI 2846 – 3026) to 2669 in 2002 (95% CI 2588 – 2751). This corresponds to a decrease of 9% (p < 0.001). A decrease of 14% was observed in the Flemish Community (p < 0.001). The reduction was very important (36%) among women aged between 75 and 89 years (p < 0.001). In the French community the decrease was not significant. The incidence of home accidents observed in general practice decreased in Belgium, especially in the Flemish Community.     

Toward understanding socio-economic inequalities in injury incidence and mortality

The existing knowledge on socio-economic inequality in injury risks is scarce and inconsistent and there is still a great need for sound epidemiological studies in this field. When performing these studies, the injury research community could benefit from the experience gained within other areas of public health. A recent project from the European Union has led, for example, to a set of proposed guidelines on several methodological aspects. Many of these are probably relevant for the injury problem field and will be addressed. Major issues are: – The distinction between individual-level and area-based studies; – The selection, measurement and classification of possible socio-economic indicators; – The expression of the magnitude of health inequalities with the help of possible summary indices; – The definition of the outcome measure (morbidity or mortality, general or specific). This paper illustrates the relevance of the aforementioned methodological issues with empirical data. Results are shown from both individual-level and area-based studies, using different socio-economic indicators and outcome measures. It is concluded that a systematic approach towards understanding socio-economic differences in injury incidence and mortality has not yet been conducted and seems highly needed. Future work in this area could benefit from experience gained within other areas of public health.     

深化中国与东南欧八国经贸合作研究

东南欧8国之间发展有较大差异,其诉求各不相同,需要采取更加精准、行之有效的方法 ,促进中国与东南欧8国的贸易。通过分析中国与东南欧8国经济发展现状及存在的问题,进而提出了完善和推进中国与东南欧8国经贸合作的路径及对策。     

Parents' perceptions, attitudes and behaviours towards child safety: a study in 14 European countries

Injury is the leading cause of death for children 0- 19 years of age in Europe, accounting for 3.1 deaths per 10 000 children per year. The youngest children of the ages 0-4 years require the most protection in this age group, with 2.5 injury-related deaths per 10 000 children in Europe annually. As parents are the primary caregivers of children, it is necessary to learn more about parents' perceptions, attitudes and behaviours towards child safety. This study presents the findings of a 14-country study in Europe on this theme. A quantitative survey of parents of children aged 5 years or under was performed in 14 EU member states in order to enable better targeting of prevention efforts aimed at educating parents. The total sample size was 2088. The results show that 95% of parents reported that they personally take measures to avoid accidental injury to their children. Their top concern with regard to safety of their children was children being hit by a car. The most common response, when asked why some parents find it difficult to protect their children from accidental injury, was not being able to watch their children constantly. Lack of awareness or knowledge about the causes of accidents was the second response. Two-thirds of parents would like to see more help from the government to prevent childhood injuries. Three-quarters of parents agreed that child injuries can be avoided. It was concluded that parents want to be better informed about the causes of child accidents and about actions they and society can take to reduce injury-related risks to children.     

Evaluation of a home injury prevention program in a WHO Safe Community

The objective of this study was to evaluate the effect of a community-based injury prevention program on home injuries. Unintentional injuries occurring in private homes and during leisure time account for 70-80% of injuries treated in public health care. A quasiexperimental design was used for the study, with cross-sectional preand post-implementation measurements in the program area and in a neighboring control community. Children and the elderly were two main target groups of the intervention program, which was based on a participative strategy for community involvement. The study was based on defined total populations. The total relative risk for home injury occurrence decreased in the study area, whereas it increased in the control area. Regarding age and gender, there was a decrease for females and males in the study area and a slight increase in the control area. For males, the youngest and oldest age groups showed no decrease, whereas females showed a decrease among the youngest and those aged 60-79. No decrease was observed in the control area. The study showed that the Safe Community approach had a general effect on the incidence of home injuries.     

Home injuries in Italy: patterns of injury and the most exposed people

Home injuries are a significant public health problem in developed and developing countries. To support future policies for reducing their occurrence and controlling their consequences, this study investigated the home injuries situation in Italy in 1999, using a nation-representative sample. The weighted correspondence analysis showed four different patterns of injury and seven profiles of the people most exposed to them. As results of this study falls were followed by bumps and cuts requiring specialist assistance then burns. Women were the most exposed to burn and fall risks and men to the risk of cuts and bumps. Among the elderly and children, falls and bumps leading to fractures, wounds or other consequences were frequent. The risks were highest for people with a lower level of education. Bumps and cuts were prevalent among unmarried and with the highest education level subjects. These injury risks were higher for young males. Cuts in adults doing do-it-yourself jobs had the worst consequences, while domestic work cuts generally did not need medical treatment. Burns occurred almost exclusively in the kitchen (90%) and did not need specialist assistance. Because home injuries are largely preventable, an efficient public health policy could promote and disseminate home safety culture.     

Drowning--a major but neglected child health problem in rural Bangladesh: implications for low income countries

This study was intended to estimate the magnitude and explore the determinants of childhood drowning in rural Bangladesh. A cross-sectional survey as well as a population-based case - control study was conducted. By multistage cluster sampling 51 147 children aged 1 - 4 years were identified from 108 827 rural households. All drownings in children aged 1 - 4 years in the preceding 5 years were identified and recruited as cases and two living children of the same age group were selected from the same localities as controls. Socio-economic, demographic, environmental and other related information was collected from mothers of both cases and controls by face-to-face interview with the help of structured questionnaires. The incidence of drowning among children aged 1 - 4 years old was 156.4 per 100 000 children-year. The highest rate (328.1 per 100 000; 95% CI 254.8 - 421.7) was observed in 1 year old male children. The proportional mortality due to drowning in the children was 27.9%. Mothers' age and literacy and family income were identified as risk factors. Drowning is one of the major causes of 1 - 4 years childhood mortality in Bangladesh. One-year-old male children from poor families were at great risk of drowning in rural Bangladesh.     

Risk factors and geographical heterogeneity in unintentional home injuries incidence rate: new evidence based on Multiscopo survey in Italy

Home injuries together, with road traffic accidents, are estimated to be the third cause of death in Italy (Arokiasamy and Krishnan 1994). However, as in most other countries, in Italy there is a lack of information on home injuries and on how differences in geographical patterns may influence the scope and magnitude of this phenomenon. By analysing a multipurpose large survey (Multiscopo) carried out annually, geographical heterogeneity in home injuries incidence rate can be investigated. The aim of this study is the assessment of possible differences in geographical patterns among the Italian regions making use of a re-analysis of Multiscopo home injury data. The study results show that Italian regions differ greatly in the number of home injuries. The geographical heterogeneity may be due to the unemployment rate and the incidence of poverty that is greater in the Southern and Insular regions than in other zones. Other socio-economic variables such as alcohol consumption can increase the risk of injury in the home. To prevent them it could be useful to organize campaigns aimed at increasing the awareness among people about this problem.     

The role of supervision in child injury risk: definition,conceptual and measurement issues

The purpose of this paper was to examine caregiver supervision and its role as an active strategy in childhood injury prevention. Through a review of the literature, the authors addressed conceptual and methodological issues related to supervision, such as the question of how to define ‘adequate supervision.’ Three critical dimensions (attention, proximity and continuity) of caregiver supervisory behaviors are identified as important areas for measurement. Presented is a framework for understanding the role of passive and active supervisory behaviors within the social context. The framework includes family and community characteristics and policies/regulations that may be important in caregiver decisions to use active or passive injury prevention strategies. Future research directions are discussed.