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Gangs, Violence, and a Flood of Migrant Children

11 Jul, 14 | by gtung

There has been a tremendous amount of media attention in the United States on what is described as a flood of migrant children illegally crossing the US-Mexico border. Statistics referenced in a recent NPR article estimate that more than 50,000 unaccompanied children have been detained by US border patrol in the last eight months.

http://www.npr.org/2014/06/20/323657817/from-a-stream-to-a-flood-migrant-kids-overwhelm-u-s-border-agents

Much of the US media coverage has also emphasized a belief of migrant children and their families that they can receive political asylum or that there are other mechanisms in place that will allow them to stay in the US once they cross. What is also starting to get more media attention are the factors pushing migrant children to take the risk of traveling long distances alone in hopes of making it into the US. A recent New York Times article does a nice job of describing the fear of gangs and violence in some Central American cities and the role it plays as a driver of the recent flood of migrant children to the US border.

http://www.nytimes.com/2014/07/10/world/americas/fleeing-gangs-children-head-to-us-border.html?src=xps

The severity of the gang and violence problem portrayed in some Central American cities in the NYT article is shocking with some city blocks described as empty and other significant internal displacement because of gangs. I can understand taking the risks of trying to make it into the US if faced with these issues. What is less clear to me is what should be done to address the gang issues that are pushing so many children to leave their homes. And then there is the heated and ongoing debate in the US about what steps if any the US should take in responding to the issue.

Greg

Hot ash burns – are we making progress?

6 Jul, 14 | by Bridie Scott-Parker

One of the best parts of being able to blog for Injury Prevention is being able to reflect upon my own experiences (personal and professional) as I learn about the research of other injury prevention researchers. I suppose today’s blog has left me feeling a little frustrated, however, that maybe we aren’t making as much progress as we could be.

This morning I came across a paper summarising the hot-ash burns experience of 50 children in Western Australia in 2011 and 2012 (see the research of Martin, Rea, McWilliams, and Wood at http://www.ncbi.nlm.nih.gov/pubmed/24280525), and this immediately led to the resurfacing of a memory from my own childhood.

As a young child (I was maybe five or six years old) I was shocked to hear that one of my friends, neighbours and best playmates had been seriously hurt during a camping holiday with her family. They had been camping, and just like every previous camping holiday, she had walked through the sand at the beach with her older brothers. The problem was that this sand was used to put out the fire which was used to cook the family’s dinner the previous night. Next day, it was if the fire hadn’t been extinguished in any way, and she sustained very serious burns to her feet.

that examined the exact same problem (eg., http://www.ncbi.nlm.nih.gov/pubmed/18182906; http://www.ncbi.nlm.nih.gov/pubmed/18789590), and made similar injury prevention recommendations.

More needs to be done if we are going to gain traction in the prevention of hot ash burns in our most vulnerable, our children.

The Benefits of Aggressive Play

27 Jun, 14 | by gtung

Is aggressive play or roughhousing something that models and facilitates violent behavior or are there benefits and if so, what are those benefits? A recently story on NPR summarizes some of the research that highlights the potential benefits of roughhousing , even forms that involve pretend violence.

http://www.npr.org/blogs/ed/2014/06/25/325218402/what-kids-can-learn-from-a-water-balloon-fight

I found the reported potential benefits of roughhousing fascinating. To get a more comprehensive list you will have to read the article and the literature but two that really got me thinking where that aggressive play and roughhousing (1) helps children learn how to resolve conflicts and regulate aggressive impulses and (2) is associated with higher first-grade academic achievement in kindergarteners.

My understanding of what might be driving some of the benefits of aggressive play (synthesized from the article) is that it creates an environment where children have to navigate complex, dynamic, and fast moving and conflict ridden social situations while regulating their own emotions.  It makes sense to me that there might be many benefits from this.

The question is where is the line (or is there a line) where this type of play, especially pretend violence, might facilitate more violent behavior in real life?

Data linkage: overcoming a potential injury prevention obstacle

23 Jun, 14 | by Bridie Scott-Parker

I am not an expert in data linkage, nor am I up to the challenge of linking various data sources, however I am acutely aware that NOT linking data is a huge obstacle for injury prevention. Without the base information which is provided by data linkage, we (and by we I am referring not only to my injury prevention researchers, practitioners and policy-maker colleagues; I am also referring to politicians, the media and others who state ‘the facts’ and control the research funds) struggle to gain accurate insight into the injury we are all working to prevent.

However, data linkage is not as simple as merging two data files (although, having said that, merging two data files is not always straightforward either!). For the uninitiated, there are a number of approaches which can be used, each with their own advantages and disadvantages. Irrespective of the data linkage method utilised, there may be additional problems which relate to the quality of the data linked, such as data completeness, accuracy and scope.

Not only are there problems in linking data files, and difficulties related to the data itself, there are also pitfalls and perils associated with actually accessing the data files. Researchers must traverse the tricky waters that are the essential paperwork of Human Research Ethics Committees. With the exception of a National Ethics Application Form, virtually every Australian injury-prevention-related institution (research and medical) uses their own Ethics form(s) and has their own mandates regarding the Ethics and research practice and process.

I hope you are not disheartened by the story so far…. Indeed, to help place the potential data linkage obstacle in perspective, Mitchell, Cameron and Bambach discuss these various issues in detail in their recent publication “Data linkage for injury surveillance and research in Australia: perils, pitfalls and potential” (see http://www.ncbi.nlm.nih.gov/pubmed/24890486).  The authors close with a recommendation for “better accessibility and use of existing data collections for injury research” as vital steps in our injury prevention pathways.

Injury prevention and the musician

16 Jun, 14 | by Bridie Scott-Parker

It doesn’t seem right that something so beautiful as music can cause terrible, enduring pain for the creator.

Miss Imogen Scott-Parker preparing for a concert

Miss Imogen Scott-Parker preparing for a concert

Sharing my home with an aspiring concert pianist (a busy young lady who has also spent years studying violin, harp, and classical voice) means I have seen first hand just what can happen through overuse, incorrect practice, or simply through not knowing what the consequences may be. She has also shared stories of the pain experienced by fellow musicians as they commit themselves – quite vigorously at times - to perfecting their craft. Such injuries can have devastating, long-term consequences, with permanent conditions meaning a change in career may not be a choice, rather the only option.

My daughter commenced her tertiary studies this year, and pleasingly one of her classes covered how to practice ‘smart’, so that less time was spent fixing more problems, thus minimising exposure to potential injury. If injured, the students were advised to cease practice immediately and to notify teachers of any discomfort and pain in particular. Students were also provided with contact details for a physiotherapist who specialises in music-related injury management.

Consistent with this advice, my daughter mentioned to her instrumental teacher that she was experiencing pain whilst practising certain pieces of music for lengthy periods. Her teacher strongly counselled her to immediately cease all practice, including typing (which is fundamentally the same movements as playing a piano), and allow her wrists, her thumbs, and her little fingers time to recuperate. Her teacher is mindful that she has relatively small, young hands (she is 15 years old) and is playing quite challenging repertoire.

Given my first-hand exposure to the realm of injury in music, I had a look through some recent publications. If you are interested, here are some interesting papers: Rickert, Barrett and Ackermann have produced a two-part series exploring injury in the orchestral environment (see http://www.ncbi.nlm.nih.gov/pubmed/24337034 ; http://www.ncbi.nlm.nih.gov/pubmed/24925177); Chan, Driscoll, & Ackermann examined the usefulness of triage services for professional orchestral musicians (http://www.ncbi.nlm.nih.gov/pubmed/23506482); and the reframing of the injury-prevention issue of likening musicians to athletes was an interesting read (http://www.ncbi.nlm.nih.gov/pubmed/24225525).

Connecting, coordination and coverage is crucial: my experiences with Fatality Free Friday

2 Jun, 14 | by Bridie Scott-Parker

Dr Bridie Scott-Parker (University of the Sunshine Coast Accident Research), Councillor Rick Baberowski, Ms Megan Cawkwell (Sunshine Coast Council) [Photo courtesy Ms Vanessa Clarke]

Dr Bridie Scott-Parker (University of the Sunshine Coast Accident Research), Councillor Rick Baberowski, Ms Megan Cawkwell (Sunshine Coast Council) [Photo courtesy Ms Vanessa Clarke]

 

Last Friday, May 28, was Fatality Free Friday (see http://www.fatalityfreefriday.com/)  here in Australia. The aim of the event is Not a single road death in Australia for just one day. Just one Fatality Free Friday.

The Fatality Free Friday website states:

We believe that if drivers are asked to actively concentrate on road safety and safe driving for just one day in the year, they’ll drive safer for the next few days too and, over time, change their outlook completely, consciously thinking about safety each and every day they get behind the wheel.

Whilst as an evidence-based practitioner and methodologically-rigorous researcher I realise that this is not necessarily the most effective manner in which to prevent injury on the road, I was delighted to participate in my the Fatality Free Friday events of my local region for the three reasons listed in the title:

1. Connecting: Injury prevention professionals need to connect – simply espousing what the evidence suggests should be done is not enough. At a fundamental level we humans are social beings, and making the connection (the fifth ‘E’ of engagement) is often the key to making any inroads in injury prevention. We need to connect with policy-makers, we need to connect with those whom we are trying to protect, and we need to connect with our colleagues-in-arms. Connecting can be as simple as speaking to one person about how they can prevent injury (for example, at the local event), translating what the research means in real words for real people (such as in my University lecture later that morning), and giving tips regarding how to stay safe to those who may not be sure what to do (like during drive-time radio).

2. Coordination: The event was organised by Sunshine Coast Council, and attending stakeholders included Transport and Main Roads, Queensland Police, Maurice Blackburn lawyers, Coastwide Driving School, motorcycle champion Chris Vermeulen, and parents and friends of those lost to road crashes in addition to myself. We all play a part in road safety, so it is important we are coordinated in our efforts whenever we can have the opportunity.

3. Coverage: I can conduct all the research I want; however if I can’t translate this into practice through connecting, coordinating and coverage, how is this going to advance the world of injury prevention? We need our research translated into the real world, and coverage is essential.

How can you be active in injury prevention?

 

Look for injury prevention ideas everywhere

26 May, 14 | by Bridie Scott-Parker

Conferences – I’m a huge fan! Regular readers of the blog will know I have shared my thoughts about the benefits of conference attendance/presentation/participation etc. Today I continue my sharing by telling you about one of the best ideas I heard at the most recent conference within which I had the great fortune to participate.

First, some background. I am a post-doctoral researcher, focusing upon improving young driver road safety. Over the years I have attended, presented at, and/or participated in a wide variety of conferences, including those more generally addressing road safety and injury prevention, and more specifically addressing particular risk factors such as adolescent psychological distress and learning-to-drive. I have found each and every one of these conferences to be an invaluable source not only of education, but, most importantly, inspiration and engagement.

Second, having said that, conferences are what you make of them. You need to listen to different ideas (and you may not necessarily agree with these, which is often the best source of inspiration), and you need to speak with others, whether they presented themselves or simply attended due to a burning interest. The sky is the limit.

Third, and my point for today – I learnt something very important at this conference. Attend conferences (and other networking/learning/engaging opportunities) outside your ‘area of interest’, and you might be surprised by what you learn, who you meet, and the range and breadth of inspired collaborative projects which may emerge. In my own case, as a trained psychologist and scientist, I had never considered attending, for example, an engineering conference. However, this makes sense. For example, civil engineers create the roads upon which all my young drivers travel; automotive engineers create the vehicles within which all my young drivers travel; computer engineers create the computer systems in the vehicles in which all my young drivers travel. Do civil engineers, automotive engineers, and computer engineers think about the young drivers who will be travelling on, through, and within their creations? I don’t know, but I will find out!

I hope I have encouraged you to ‘think outside the box’.

 

Harborview Injury Prevention Research Centre has new director

15 May, 14 | by Barry Pless

monika1

I just spotted this important announcement. I am not sure who preceded Fred Rivara as Director of this outstanding Injury Prevention Research Centre, but I do know he was followed by David Grossman and Beth Ebel. Now a new director has been named. As the announcement states, “Dr. Vavilala is Professor of Anesthesiology and Pediatrics and Adjunct Professor of Neurological Surgery and Radiology at the University of Washington. She received her undergraduate education from the University of Houston and her medical degree from University of Texas Medical School in Houston, Texas. She completed two residencies, her first in pediatrics at the University of Texas Medical School and the second in anesthesiology at the University of Washington. Dr. Vavilala is an expert in the care of injured patients, has authored over 150 peer reviewed publications related to injury, and is internationally known for her work in traumatic brain injury. As a 20 year faculty member in the UW School of Medicine, she has mentored over 27 fellows across UW, has current research support from the National Institute of Neurological Disease and Stroke, and is the co-director of the NICHD sponsored UW Pediatric Injury Training Program.”

Fred Rivara notes that “Dr. Vavilala is the first anesthesiologist in the nation to lead an injury research center and the only anesthesiologist on the Brain Trauma Foundation Guidelines working group pertaining to the acute care management of patients with severe traumatic brain injury. “

From evidence to policy and practice

13 May, 14 | by Bridie Scott-Parker

Regular readers of the Injury Prevention blog will be quite familiar with my obsession for getting our rigorous research translated into policy and practice. I regularly hear from individuals in industry and government, not to mention the general community, that researchers are great at communicating with other researchers, and not so great at communicating with ‘normal people’. Upon hearing this I have decided to create one-page summaries of my journal articles and conference papers, in plain English, summarising for the ‘normal person’ what I did, what I found, and what it means for them.

So you can understand my delight at reading an article published in a recent edition of Social Science & Medicine (see http://www.ncbi.nlm.nih.gov/pubmed/24632115). Zardo, Collie and Livingstone decided to wrangle with the twofold problem of getting research translated into policy and practice: “identify external factors that affect policy and program decision-making, and use this evidence to inform targeting of interventions aimed at increasing research use (in the context of injury prevention and rehabilitation compensation in Victoria, Australia)”.

Interestingly the interviews with employees from two state government agencies revealed that the following stakeholders were most influential, suggesting that researchers need to target these stakeholders if they are to be influential in  government policy and practice.

* the Minister and the government,

* lawyers, and

* agency stakeholders, including health providers, trade unions, and employer groups.

I love the idea of working smarter, not harder!

Motorcycle crashes decline: thank the weather

7 May, 14 | by Barry Pless

This is verbatim from FairWarning, increasingly one of my favourite and most respected go-to sites:

Preliminary figures show U.S. motorcycle fatalities falling 7 percent in 2013 as bad weather kept riders off the road. A report by the Governors Highway Safety Association projects that the number of motorcyclists killed last year will total 4,610, down from 4,957 in 2012 and nearly identical to the 2011 figure of 4,612. It is only the second time in the last 15 years that such fatalities have declined. Still, the association’s figures show that people in passenger vehicles are about twice as safe as they were in 1997, while there has been no improvement since then for motorcyclists, largely due to declining use of helmets. As FairWarning has reported, biker groups have pushed lawmakers and regulators to back away from promoting or enforcing requirements for safe helmets, the best way known to save bikers’ lives. The Washington Post, Forbes – See more at: http://bit.ly/1mHIQ8r

Editors note: This is another good reminder of how essential it is to pay close attention to changes in exposure whenever injury rates change, in either direction.

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