Caring for older people: an analysis of the small business sector

This study aims to analyse the small business sector in Spain for institutional care. In the Autonomous Region of Valencia, this sector is represented by non‐profit institutions. Our results show that non‐profit centres easily fulfil the legal requirements, especially with regard to personnel. They are generally of high quality and receive a large amount of volunteer work and funds from donators. Small business centres show an accurate daily cost per user of up to €56.48, a substantially lower rate than those offered by large centres.     

Hospitalized fall-related injury trends in Sweden between 2001 and 2010

Previous studies have indicated increasing trends of hospitalized fall-related injuries amongst elderly. Whether this is true also in Sweden is unknown though it is important to study considering the potential societal impact. Data were obtained regarding hospitalized injuries with falls as external cause among those aged 65 years and above with information on injury type, gender and age, on a yearly basis, from 2001 to 2010. Age- and sex-specific incidence rates were calculated (per 100,000 population) for all fall-related injuries, and for each injury type and trend lines were drawn. Linear regression analyses and percentage change were calculated for the types of fall-related injuries. A decreasing incidence was observed in the younger age groups (65–79 years) with greater decreases amongst women (women: ?14.6%, men 65–79 years: ?10.5%). However, increasing rates were observed in the older age group (80 years and above), with greater increases amongst men (women: 4.3%, men: 11.4%). Superficial injuries showed greater increases than fractures amongst those aged 80 years and above. This study indicates that older elderly in Sweden are increasingly being hospitalized for less serious injuries. This changing injury panorama is important to include in the future planning of both health care and fall-related prevention.     

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.     

退休老年人身体形态与力量素质相关关系的研究

近年来老年人的身体健康现状日益成为人们关注的焦点问题之一,为了对退休老年人的身体健康状况有进一步的了解,对58-68年龄段退休老年人进行身体形态和力量素质的测试。研究发现身高与握力（r=0.659）、体重和握力（r=0.655）均有显著相关性,且呈正相关趋势,身高与体重（r=-0.243）呈负相关。因此在适度原则下,应加强以力量素质为主的体育锻炼,其对于提高身体素质,增进健康有非常重要的意义。     

Experience,change and vulnerability: consumer education for older people revisited

Everyday consumer transactions have the same potential for unexpected consequence whatever the age of the consumers involved. Young and old alike can find that products and services fail to live up to performance claims and that they are left with problems not easily resolved, or costs that are difficult to recover. While not overlooking consumer heterogeneity – especially on the basis of age – older consumers are arguably distinguishable in terms of the social and financial context in which they make decisions and attempt to redress problems. In 1988, attention was drawn to the need for consumer education to look beyond generic objectives to the specific situation of older people and their transactions. More than a decade later, in an allegedly consumer‐oriented society, the issue is revisited here to assess the argument's current relevance. Despite the increased availability of information for decisions and consumer protection, difficulties persist in the way information is presented or accessed. Chameleon‐like, old problems become manifest in new unfamiliar ways and invalidate experience. Consumer education today is as important as it was in 1988. Arguably, technological change means that the need for a better understanding of dangers, rights and redress procedures is greater than ever and the needs of older people in increasingly complex private and public sector transaction environments are all the more pressing. However, a fundamental revision of the way we approach the design of products, services and environments is needed to improve prospects for older consumers.     

The establishment of injury surveillance in Thailand

The Provincial Injury Surveillance System was initiated in Thailand in 1993 to establish a database for assessment of the quality of acute care and referral services provided to the injured at the provincial level, and to facilitate injury prevention and control at both local and national levels. An injury surveillance system model that adopted a trauma registry as the record form, was established in five selected large hospitals, one from Bangkok and four from major regions of Thailand. Data analysis was undertaken and utilized at both local and national levels. The Epidemiology Division of the Ministry of Public Health supervised and assessed the data quality. Evaluators from the School of Public Health identified problems in operating the system at the provincial level and assessed the feasibility of expanding the project. The data of 66,895 injuries including 1,755 deaths reported in 1995; revealed fundamental problems in the emergency medical services. Causes of major injuries were identified and their epidemiology described. The coverage of reporting was over 90%. The completeness and reliability of recording ranged from 80.6–100%. This model of sentinel surveillance is appropriate for injury problems, which are of large magnitude and are at the early phase of problem solving. Development of the information systems administration and human resource in computer technology are necessary to cope with the problems of increased workload in data collecting and processing. This model of surveillance is feasible for expansion but its data system has to be appropriately integrated into the existing systems of the hospitals.     

Trauma epidemiology in Puerto Rico: in-hospital morbidity and mortality from 2002 to 2011

This study aimed to describe the distribution of injury mechanisms and to assess the impact of those mechanisms on the morbidity and mortality of trauma. All patients admitted to Puerto Rico Trauma Hospital (2002–2011) for road-traffic collisions (RTCs, 5,371), gunshot wounds (GSWs, 2,946), falls (2,319), pedestrian accidents (1,652), and stab wounds (SWs, 1,073) were selected. Gunshot victims were 1.19 (95%CI: 1.07–1.33) times as likely as road-traffic victims to have an ISS ≥25. Pedestrians were 1.76 (95%CI: 1.49–2.09) times more likely to have a GCS ≤8 than road-traffic victims were. The risk of dying was 2.64 (95%CI: 2.20–3.16) times higher for gunshot victims and 1.51 (95%CI: 1.23–1.86) times higher for pedestrians compared to patients who had had RTCs. Gunshot victims and pedestrians had the worst clinical outcomes. Accordingly, these patients should receive the most aggressive clinical management. Furthermore, it is imperative to develop public health campaigns on trauma prevention.     

Determinants of severe injury and mortality from road traffic accidents among motorcycle and car users in Southern Thailand

Abstract

This study aimed to identify factors associated with severe injury and mortality from road traffic accidents (RTA) among motorcycle and car users in southern Thailand. The data were obtained from the Office of Disease Prevention and Control, Thailand, for years 2008–2013. Chi-squared tests were used to assess associations between determinants and outcomes and these associations were then estimated after adjusting for possible confounding with other factors using logistic regression. Severe injury and mortality contributed 11.6% and 5% to RTA of motorcycle users, and 14.3% and 7.5% for car users. Among motorcycle users, male gender, older age, and not wearing a helmet increased severe injury and mortality rates, whereas drivers had more severe injuries than passengers. Older car users had higher severe injury and mortality rates, whereas not fastening seat belts had higher mortality. Safety device use should be made mandatory for both drivers and passengers. Male motorcycle users and the elderly should be focused on.     

Transport safety for older people: A study of their experiences,perceptions and management needs

With evidence of increasing accident risk due to age-related declines in health and cognition affecting driver performance, there is a need for research promoting safe mobility of older people. The present study aimed to identify transport options and licensing issues for a group of older people in an Australian community. Ninety-five participants aged 75 and over were interviewed about their driving status and accident record and tested for cognitive ability. After stratification on cognitive level and driver status (current, ex-driver or non-driver), 30 were selected for further in-depth interviews concerning demographics, licence status and impact of change, travel options available and used, and travel characteristics. Considerable reliance on the motor vehicle as the mode of transport and the decision to cease driving were major quality-of-life issues. There was little evidence of planning and support in making the decision to stop driving. Some differences in transport decisions on the basis of cognitive level were evident; however, people with severely compromised cognitive ability (and, therefore, unable to give informed consent) had been excluded. The study suggested the need for resources to assist older people/carers/health professionals to plan for the transition from driver to non-driver and to manage alternative transport options more effectively.     

The perception of fire risk by older people and its impact on relevant fire safety education

Accidents due to ‘fire and flames’ are second only to “falls” as the most important cause of accidental death in the homes of elderly individuals throughout the United Kingdom. This study aims to ascertain whether older people are receiving fire accident advice appropriate to their needs. A questionnaire addressing the issues of risk perception, fire preventative action and access to fire safety information was distributed to 1100 randomly selected members of the ‘Thousand Elders’ (a nation-wide consumer group established by the Centre for Applied Gerontology at The University of Birmingham, comprising people above the age of 50 years). Eight hundred and four questionnaires were returned and were analysed using the Statistical Package for Social Sciences. Fire risk was perceived as far less of an immediate threat than the danger of a personal attack by an intruder in the home. Recognition of fire risk and the effectiveness of fire safety measures did not result directly in safety appliances being fitted. The majority of ‘Elders’ had received no fire-fighting training, yet more than half felt confident in tackling a small fire. Neither did experience of a fire in the home necessarily increase action towards safety precautions. The majority had not been exposed to a fire safety campaign in the past 12 months. On exposure to a campaign, the impact towards fire safety was positive. The educational process should aim to close the gap between the recognition of the need for fire safety precautions and the implementation of fire safety measures. The key to effective fire prevention amongst older people depends upon: Information, Training and Support, i.e., relevant information supported by practical help and subsequent practical training in-situ by trusted community figures.     

Reaching those at highest risk to fires and burns: Young children,older adults,and people in low-income communities

Injury specialists have not successfully convinced policy makers and the public that injuries can be controlled. That failure may be due in part to the lack of a unified understanding of injury control. The two most important models utilized in injury control are Haddon's Matrix1 and the Public Health Approach (PHA). This paper argues that the PHA should be combined with the two axes of Haddon's Matrix to result in a model that is coherent and comprehensive. Thus it is better than either one of the original models on their own. Haddon's Matrix has two axes. The first includes elements of the epidemiological triad, host, vector, and environment and likens injury to disease. The second axis includes three time intervals, pre-event, event, and post-event. The importance of including time was that injury was conceptualized as predictable and preventable. The weakness of Haddon's matrix is that it lacks a systematic plan of action. The Public Health Approach is a methodology for addressing injury, which consists of a hierarchy of four levels; surveillance, risk factor identification, intervention evaluation and program implementation. The use of the PHA with no specific orientation or means of application is its weakness. The PHA lacks a systematic point of application. Haddon's Matrix lacks a systematic action plan. Therefore we propose the PHA as the systematic strategy for the more theoretical framework of Haddon's matrix. By combining these concepts a coherent and comprehensive three-dimensional framework is defined. The unified model closes the potential gaps in the two original models and includes a systematic approach not previously achieved. This unified model is practical in defining individual studies and groups of studies. It can be used as an inventory, for a complete understanding of a particular injury. Diagrams of the model are presented to help teach the concepts of injury described in this unitary model. In conclusion, we can say that the inclusion of three injury concepts in one framework provides a rigorous and coherent construct for the understanding of injury and implementation of control activities. It can therefore be used to design more comprehensive programs for injury control and promote policies and funding commensurate with the magnitude of the injury problem.     

Regionalization in Central and Eastern Europe

SUMMARY

Regional players among the MNCs operating in Central and Eastern Europe have to decide if they should regard their businesses as a collection of individual markets or as a homogeneous region. The purpose of this paper is to examine if and how regionalization concepts have actually been implemented by foreign MNCs in CEE. The analysis focuses on the preconditions for the emergence of a regional strategy, on the identification of the main areas of regional integration, and the relationship between strategy and organizational structure. By using a longitudinal case study approach a better insight is gained on how regional strategies have emerged during the internationalization process of the firm and, if they have emerged, in which way they have manifested themselves in business decisions. The findings raise new questions about the regionalization construct with regard to the operationalization of regionalization, the relationship between strategy and structure, and its applicability to services.     

Injuries,inequalities and health in Europe

Injuries account for a significant burden of mortality, morbidity, disability and health care costs. They differentially affect age and sex groups and reveal massive inequalities in occurrence within and between countries in Europe. Within countries, the poor suffer most and have least ability to change their exposures to risk. Addressing inequalities in injury occurrence would play a valuable role in reducing the differential burden of ill-health between rich and poor. Despite the evidence for many effective injury-related interventions, limited attention has been devoted to addressing injuries as a public health priority. This paper questions why attention has been limited to date and suggests policy action to support injuries being addressed as a mainstream concern by national and international health policy-makers. The paper briefly highlights the public health burden of injuries and violence; illustrates the range of inequalities that characterise their occurrence; highlights the scope for public health action and considers the extent to which policies that reduce the overall burden of injuries may also reduce inequalities in their occurrence; and finally examines why there has been a limited policy response to date and suggests ways of advancing the agenda.     

Trade and Market Liberalisation in Eastern Europe

SUMMARY

The question of why multinational companies (MNCs) choose to locate in one region rather than another has been an important topic in IB research for many years, but has recently received even more attention. This paper presents the results of an econometric investigation of the locational determinants of Italian firms in Central and Eastern Europe. Italian firms have been very active investors in the CEE countries. Our results broadly confirm the findings of previous studies, but we also find that both trade liberalisation and market liberalisation are important influences upon the location decision. If the CEE governments wish to attract further (Italian) foreign investment, then further liberalisation of their domestic economies should be a policy priority.     

中国中小企业的生存环境

中小企业在国民经济中占据着重要地位，但是近年来中小企业的数量、所创造的国内生产总值及利税比重都趋于下降。从中小企业产业组织、宏观经济状况、经济政策、法制环境、融资渠道、社会负担、社会观念和社会化服务体系等八大方面分析我国中小企业的生存环境。     

Subsidiary autonomy and performance in Japanese multinationals in Europe

Notwithstanding the growing body of research on headquarters–subsidiary relationships, the conditions under which subsidiary autonomy leads to enhanced subsidiary performance is still a subject of debate. This study adopts a contingency approach and investigates the effects of external uncertainties and intra-MNE coordination on the performance benefits of subsidiary autonomy. The empirical analysis is based upon cross-sectional data collected from 88 European subsidiaries of Japanese MNEs. Our findings show that subsidiary autonomy has a greater impact upon performance (a) under conditions of technological uncertainty; and (b) when expatriate involvement is high, as the subsidiary can reap the full benefits of entrepreneurial capabilities and enjoy resource interdependencies through interactions with the parent simultaneously. MNC executives should aim for an appropriate balance between subsidiary autonomy and these internal and external factors so that the subsidiaries achieve superior performance.     

Skiing and snowboarding injuries and their impact on the emergency care system in South Tyrol: a restrospective analysis for the winter season 2001–2002

Objectives. To evaluate the incidence and the pattern of skiing and snowboarding injuries in South Tyrol and their impact on the emergency medical system in the winter season 2001–2002 in an attempt to rationalize and improve the emergency care and assist in prevention strategies.

Methods. All medical records of patients referred to our emergency department (ED) that sustained a skiing or snowboarding injury during the study period were retrospectively reviewed. Age, sex, local or non-local residency, type of injury, data and time of accident, type of transport to the hospital, hospital admission or ED discharge, Injury Severity Score, outcome (including mortality) were evaluated. On site mortality data were obtained from the emergency call-center registry. Ski resorts utilization was estimated from the data published by the Regional Office of Cable Transport.

Results. For the period analyzed approximately 2,500,000 skier and snowboarder days were recorded in the whole region of which about 500,000 were attributed to the four nearby ski resorts that refer to our hospital. Of the 1087 patients, 794 were skiers and 294 were snowboarders. Snowboarders were younger than skiers (mean age 20 and 36 respectively, p = 0.001). Females were equally represented in the two groups. Male patients, children, senior skiers and non-local residents suffered from more severe injuries than their corresponding classes (p < 0.01, p = 0.002, p = 0.02, p = 0.000 respectively). Critical injuries (ISS ≥ 25) were homogeneously spread in the groups, with the exception of the non-local resident patients that showed a higher incidence (p < 0.02). No difference in severity was found between skiers and snowboarders. The incidence was 2.05 per 1,000 skier-days. Mortality rate was 1.6 per 1,000,000 skier-days. The pattern of injury was different: snowboarders showed more forearm and wrist trauma and skiers more lower extremity injuries. 208 patients were hospitalized and the mean length of stay was 4.5 days. Head trauma and fractures were the most common diagnosis of admission. The lack of field triage led to 12% of unjustified helicopter transfer and 9.6% of avoidable ambulance transport.

Conclusions. Incidence, pattern of injuries and mortality from skiing and snowboarding accidents in South Tyrol resemble those reported in other part of the world. Nevertheless, strategies for prevention are needed. The routine use of helmets should be enforced by law. Dangerous behaviors should be prosecuted. Skiers and snowboarders should be made aware that skiing beyond their technical ability can be life-threatening.     

氟表面活性剂在石油和消防领域的应用

首先介绍了氟表面活性剂的优良性能和广泛用途 ,然后重点说明了氟表面活性剂在石油和消防领域的应用 ,主要包括驱油添加剂、破乳剂、集油剂、轻水灭火剂和氟蛋白泡沫灭火剂等。     

宏观政策的协调机制与欧洲债务危机

通过政策调整损失函数的理论模型分析,认为负的需求冲击是构成欧洲债务危机的前提,而缺乏货币政策协调的持续性扩张财政政策是欧洲债务危机的本质原因。对2000Q1—2010Q1的"PIIGS"的季度数据进行实证分析后,发现5国独立财政政策和欧元区共同货币政策的协调机制是存在冲突的。希腊长期均衡和短期调整均存在主权债务危机风险,因而成为首个爆发危机的国家。西班牙、意大利的短期调整虽暂时缓解了主权债务危机出现的可能,但不能解决发生危机的根本问题。而爱尔兰、葡萄牙只是短期内实施了过度的积极财政计划而造成了主权债务危机假象。