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Offbeat

Special online issue of Injury Prevention

25 Mar, 15 | by Barry Pless

In a recent email, the editor of Injury Prevention, Brian Johnston, announced that in recognition of the Journal’s 20th Anniversary a special online issue was available. This features “some of the best papers in global injury prevention” that ordinarily would have been presented at the Safety 2014: the World Conference on Injury Prevention and Safety Promotion. Unfortunately, the Conference, scheduled to convene in Atlanta last year, was cancelled for various reasons known only to a few. As Brian notes, despite what some have written about the value of such conferences, these biennial meetings provide an excellent “opportunity for members of our disparate community to meet one another and share ideas, often informally. Apart from Brian’s editorial, the issue includes an assessment by WHO’s injury leader, Etienne Krug of the state of the discipline from a world-wide perspective. Please note that the content of the special issue will only be free to read online through the end of April.

 

To make life simpler for our readers, here is a list of the contents:

 

Editorials

 Safety 2014: global highlights in injury prevention B D Johnston

 Next steps to advance injury and violence prevention EGKrug

Original articles

Costs of traffic injuries M Kruse

Rates of intentionally caused and road crash deaths of US citizens abroad M K Sherry, M Mossallam, M Mulligan, A A Hyder, D Bishai

Bus stops and pedestrian–motor vehicle collisions in Lima, Peru: a matched case–control study
D A Quistberg, T D Koepsell, B D Johnston, L N Boyle, J J Miranda, B E Ebel

The association of graduated driver licensing with miles driven and fatal crash rates per miles driven among adolescents M Zhu, P Cummings, S Zhao, JHCoben,GSSmith

Official blame for drivers with very low blood alcohol content: there is no safe combination of drinking and driving D P Phillips, A L R Sousa, R T Moshfegh

Extending the value of police crash reports for traffic safety research: collecting supplemental data via surveys of drivers D R Durbin, R K Myers, A E Curry, M R Zonfrillo, K B Arbogast

Unintentional drowning mortality, by age and body of water: an analysis of 60 countries C-Y Lin, Y-F Wang, T-H Lu, I Kawach

Children reporting rescuing other children drowning in rural Bangladesh: a descriptive study T S Mecrow, A Rahman, M Linnan, J Scarr, S R Mashreky, A Talab, AKMFRahman

Socioeconomic and disability consequences of injuries in the Sudan: a community-based survey in Khartoum State S E Tayeb, S Abdalla, I Heuch, G V den Bergh

Supervision and risk of unintentional injury in young children P G Schnitzer, M D Dowd, R L Kruse,
B A Morrongiello

Incidence, characteristics and risk factors for household and neighbourhood injury among young children in semiurban Ghana: a population-based household survey A Gyedu, E K Nakua, E Otupiri, C Mock, P Donkor, B Ebel

Risk of fatal unintentional injuries in children by migration status: a nationwide cohort study with 46 years’ follow-up N Karimi, O Beiki, R Mohammadi

Occupational noise exposure and noise-induced hearing loss are associated with work-related injuries leading to admission to hospital S-A Girard, T Leroux, M Courteau, M Picard, F Turcotte, O Richer

Deaths due to injury, including violence among married Nepali women of childbearing age: a qualitative analysis of verbal autopsy narratives K T Houston, P J Surkan, J Katz, K P West Jr, S C LeClerq, P Christian, L Wu, SMDali,SKKhatry

Sexual violence experienced by male and female Chinese college students in Guangzhou C Wang,
X Dong, J Yang, M Ramirez, G Chi, C Peek-Asa, S Wang

Brief reports

The implications of the relative risk for road mortality on road safety programmes in Qatar R J Consunji,
R R Peralta, H Al-Thani, R Latifi

Seatbelt and child-restraint use in Kazakhstan: attitudes and behaviours of medical university students
Z S Nugmanova, G Ussatayeva, L-A McNutt

Are national injury prevention and research efforts matching the distribution of injuries across sectors? H Jaldell, L Ryen, B Sund, R Andersson

Firearms and suicide in US cities M Miller, M Warren, D Hemenway, D Azrael

Methodology

How well do principal diagnosis classifications predict disability 12 months postinjury? B J Gabbe,
P M Simpson, R A Lyons, S Polinder, F P Rivara, S Ameratunga, S Derrett, J Haagsma, J E Harrison

Counting injury deaths: a comparison of two definitions and two countries T-H Lu, A Hsiao, P-C Chang,
Y-C Chao, C-C Hsu, H-C Peng, L-H Chen, I Kawachi

Assessing the accuracy of the International Classification of Diseases codes to identify abusive head trauma:
a feasibility study R P Berger, S Parks, J Fromkin, P Rubin, P J Pecora

Systematic reviews

An international review of the frequency of single-bicycle crashes (SBCs) and their relation to bicycle modal share P Schepers, N Agerholm, E Amoros, R Benington, T Bjørnskau, S Dhondt, B de Geus, C Hagemeister, BPYLoo,ANiska

Inequalities in unintentional injuries between indigenous and non-indigenous children: a systematic review
H Möller, K Falster, R Ivers, L Jorm

 

Participants and researchers: An interesting approach

22 Mar, 15 | by Bridie Scott-Parker

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Last weekend I had an opportunity to see first-hand an interesting approach for participants and researchers in action. Unfortunately I have a medical condition which means I experience neuropathic pain (this is NOT fun!). Therefore I am always on the look-out for any new research regarding managing (and ideally, minimising) pain. The general consensus seems to be that the experience of pain is indeed very complex, and as such pain management requires a complex approach (for example, see the recent research of Tsay, Allen, Proske, and Giummarra).

In my travels I came across the Living Well with Pain Consumer Symposium. This was the detail I received in the invitation:

Painaustralia invites you to attend Living Well With Pain – a consumer symposium to be held at the Brisbane Convention & Exhibition Centre. Leading Australian experts on pain management will discuss new knowledge about pain, its links with depression and effective ways of communicating and managing pain with and without medication.

This will be of interest to all people living with pain, their families, carers and many others, including policy makers, healthcare professionals and students. Participants will be invited to contribute to a consumer forum, to discuss ideas for improving pain services, locally and potentially, Australia-wide.

I am used to going to conferences where I present my latest research findings to an audience which generally includes other researchers, practitioners, and policy-makers. Attending the Symposium as a person who experiences pain was a totally different experience for a number of reasons. Firstly, as researchers we often forget that each participant (or in this case, patient) is a real person with a complicated life and complicated experiences despite our best efforts to whittle them down to a finite set of characteristics and behaviours. Second, do we give our participants a voice, or do we just think that we give our participants a voice? Third, do we share our findings with our participants? How can we use what we learn to improve the experiences of our participants sooner rather than later (if at all)?

The Symposium was part of the 2015 Australian Pain Society 35th Annual Scientific Meeting Managing Pain: From Mechanism to Policy” which was held in the same venue. Researchers presenting at the scientific meeting also presented at the Symposium – what a fantastic way to get participants/patients and researchers on the same page!

 

 

 

 

 

 

 

 

The Mysterious Green Hand

24 Feb, 15 | by Barry Pless

FullSizeRenderI voted for the design of the Journal’s new cover even though I was not sure why I liked it better than the alternatives. I’m pleased that whatever attracted me to it pleased others as well. But, from the start, the small green hand has puzzled me. It seemed a bit mysterious and not just because it cleverly merged into the background. I’m still not sure what it is intended to represent. The red is obvious: it is what most injury prevention messages say, “Stop; don’t go here.” Or, “Don’t do this; it’s dangerous and could cause a serious injury.” So, the red hand is no mystery. But the green hand is another matter. It could mean many things.

 One thing I hope it is not intended to convey is that the Journal encourages risk-taking. I know some regard my opposition to this as foolish, but even if I’m wrong, at least I’m consistent because I’ve held this view for many years. Recently, however, some distinguished colleagues insisted that I was wrong because they were convinced risk-taking is essential for healthy child development. They even argued that risk avoidance was itself ‘harmful’. When I asked for evidence in support of these assertions they insisted that not all evidence needs to be ‘scientific’.

 Respectfully, I disagree. I am not an evidence-based evangelist but I do believe that there is a clear hierarchy in the many paths to knowledge. Most scientists agree that clinical wisdom, years of experience, or the convergence of opinions from diverse disciplines is not equivalent to what we learn from disciplined, well-designed research. They (and I) believe the best evidence comes from true experiments but we accept that these are often impossible in a field such as ours. So we often resort to quasi-experimental designs. But I hope there are not many among us who would accept that ‘proof’ of a position can comfortably rest only on anecdotal accounts or personal experience.

 Back to the green hand: I repeat that I trust it is not intended as a symbolic nod to those who are convinced that risk taking is essential to healthy development or even a good way to prevent injuries. Instead, I hope it is intended to say something like, ‘Follow me along this path. Evidence suggests it may be risky but it is safer than the alternatives.’ In other words, the green hand is intended to remind us that there is a middle ground. For example, some communities in the US and Canada have recently banned tobogganing on hills that were found to be extremely dangerous. I think this makes good sense. However, many of these and other communities pointed users to hills that are far less dangerous because icy patches and obstacles have been removed. 

I hope the green hand is there to wave us towards safer alternatives but NOT to urge abandoning reasonable caution.

 PS. I urge, beg, implore all who disagree to submit comments to this blog. Let’s liven things up and debate our views vigorously.

Cyclones down under

23 Feb, 15 | by Bridie Scott-Parker

Summer and cyclones – they seem to go together down under. Here in Queensland, we copped another battering over the last couple of days courtesy of category 5 Cyclone Marcia.

Each cyclone has the capacity to reawaken slumbering memories of other cyclones. For many Queenslanders, 2011 Cyclone Yasi is still very fresh in our memories. In the aftermath of the storm which was more than 600 kilometres wide, a record 99% of our state was declared flooded. Our children watched inside for close lightning strikes as my husband and I filled sandbags. Helicopters flew over our house with sirens alerting us to evacuate. How? To where? Our road was under fast-flowing water, and even if we could get through, all roads leaving our region to the north, the south, and the west (the ocean is to the east) were underwater. We had a plan, though – we were going to throw everyone in our neighbour’s boat, and tie my mother in her wheelchair to some inflatables and sail out if it came to that! Panicked hilarity, but it kept us sane when we had no land phone lines, no mobile communication options, and no way of knowing if any of our family members were washed away, for days.

Post-cyclone, I understand the focus on communicable diseases – the ensuing water creates the perfect home for creatures like mosquitoes which transmit some pretty nasty diseases. However, this morning I was pleased to see a paper by Ryan, Franklin, Burkle, Watt, Aitken, Smith and Leggat: Analyzing the impact of severe tropical cyclone yasi on public health infrastructure and the management of noncommunicable diseases. Having seen first hand the damage of Yasi, and knowing well the pervasive impact of noncommunicable diseases, this research tackles an issue relevant for all jurisdictions in our (at-times) temperamental home.

We continue our post-Marcia clean-up, but the latest sandbags are staying in close reach!

 

 

 

 

 

Crotchety post?

9 Feb, 15 | by Barry Pless

I recently came across a posting on some website or other about a ‘new study’ that discovered that poverty is linked to children’s injuries!! Am I alone is wishing that editors would resist publishing studies that simply repeat what is already well known? When a Journal asks authors to state “what this study adds” or something along those lines, I think reviewers need to look carefully at what is written and decide if the paper in their hands is not simply a ‘me too’.  And, please don’t say that some repetition is justified because it has never been shown to be true for Little Forks, Stateville, Timbucktoo before!

Or am I simply being too crotchety on this cold, miserable Monday in Montreal? And, yes, before I am leapt upon too vigorously, I do agree that most new findings require replication. But come on…. there must be a limit to how often a well documented finding can be reported!

Mentor VIP

9 Feb, 15 | by Barry Pless

I received this email from David Meddings. This excellent program seeks volunteers. Do consider doing so.

Dear MENTOR-VIP participants (past and present),

Applications for the ninth cycle of MENTOR-VIP are now open. This means individuals wishing to apply to be mentored during 2015-2016 may make their applications via our website (link given below) between now and May 8.

As you know, MENTOR-VIP is designed to assist junior injury practitioners develop specific skills through structured collaboration with a more experienced person who has volunteered to act as a mentor. The programme provides a mechanism to match demand for technical guidance from some people with offers received from others to provide technical support.

Mentoring arrangements may take place in whatever language or languages the mentor and mentee are comfortable to communicate in. The majority of interaction between mentor and mentee takes place through low cost electronic communication such as email, internet-based telephony, or telephonic exchange.

I would appreciate if all of you could take steps within your own communications to make people aware that the programme is now accepting applications. The main message for potential candidates is that applicants who wish to apply for one of the available positions must do so by the application deadline of May 8 through the capacity building section of WHO Headquarter’s website for injury and violence prevention.

All applications to the programme are made online and more detailed information is available at http://www.who.int/violence_injury_prevention/capacitybuilding/mentor_vip/.

Please feel free to forward this email within your networks and do let me know if you have any questions.

Best wishes,

David Meddings

Applications for MENTOR-VIP are now open
Do you work in the injury and violence field and want to improve your skills?
MENTOR-VIP is a global mentoring programme for injury and violence prevention developed by WHO and a global network of experts. Applications for mentees to be mentored during the 2015-2016 period are now open through May 8, 2015.
To find out more, or to submit your application to be mentored please go to:

http://www.who.int/violence_injury_prevention/capacitybuilding/mentor_vip/Mento

Workshop blog correction

2 Feb, 15 | by Bridie Scott-Parker

My apologies, it seems I need tuition in proof-reading! I mistakenly omitted Dr Ted Miller, Injury Prevention, as one of the Editors who will be leading the discussion at this great workshop.

SAVIR 2015 Workshop

1 Feb, 15 | by Bridie Scott-Parker

The very interesting workshop, Nurturing a Successful Academic/Early Professional Publishing Career, will be held at the SAVIR 2015 conference in New Orleans next month. The workshop will be held from 4.45pm to 6.00pm in the Oak Alley room, Sheraton Hotel.

Why are we holding this workshop? Because academic environments expect early career professionals to publish for their advancement in their career yet many university programs provide limited opportunities to their students to develop these abilities. The aim of this roundtable is to provide such opportunity for students and early career professionals in an informal setting. In this event, students and early career professionals will be able to closely interact and discuss with editors of leading injury research journals on the issues of identifying the right journal for your manuscript, writing informative abstracts, reporting statistical information, and how to address reviewer comments. This session is aimed at enhancing the capacity on improving the writing skills of early career injury researcher.

There will be two parallel roundtable sessions covering issues related to scientific manuscript preparation and publication. Discussions will focus on the following topics: writing informative abstracts,  how to address reviewer comments, how to identify the right journal for your manuscript, tips and suggestions for overcoming writers block, reporting statistical information: do’s and don’ts, and finally some common mistakes that you see made by researchers when publishing.

The roundtables will be limited to a total of 13 and 12 participants including the discussion leaders. The editorial board will consist of Dr. , Injury Prevention; Dr. Linda Degutis, Injury Prevention, Dr. Guohua Li, Injury Epidemiology; Dr. Frederick Rivara, JAMA Pediatrics; and Dr. Shrikant Bangdiwala, International Journal of Injury Control and Safety Promotion.

Don’t miss out – register for the workshop now!

 

All-terrain vehicles: How do we effectively prevent injury with incomplete injury surveillance data?

23 Jan, 15 | by Bridie Scott-Parker

My very first blog – two years ago this month (!) – was on the topic of injuries sustained when using all-terrain vehicles. Growing up in a rural Australia, quad-bikes were a common and viable option to horses when mustering, checking fences, checking water, setting traps, etc. Since moving to the city as a young adult, and now working in a region that is one of our state’s most popular holiday destinations, I see quad-bikes used for recreation rather than for work. The injury risks for the rider remain the same, however, and I personally find myself attuned to any news reports in which a rollover or other crash had occurred (a couple from Queensland in the last couple of weeks: Three riders one bike; Young boy; Lady rider; some inquest discussions).

Yesterday I came across an article which examined the reporting of quad-bike-related injuries in data collections in New South Wales during 2000-2012. Mitchell, Grzebieta, and Rechnitzer used the World Health Organization (WHO) injury surveillance guidelines as their benchmark. None of the five datasets recorded all of the core minimum data items or the core optional data items. With respect to the core minimum data items, only the injured person’s age and sex was consistently reported, with much variation in the recording of core injury characteristics such as the place of occurrence and the nature of the injury.

Further hampering injury prevention efforts, the Authors note a “general lack of information regarding the make, model, and engine sixe of the quad bike, whether any ROPS, attachments, or loads were affixed to the quad bike or whether any objects were being tow3erd by the quad bike….whether the individual was wearing either a helmet or a restraint was not often collected.”

I have blogged many times regarding the need for quality injury surveillance data – I would argue that at this time, certainly in New South Wales, this appears to be lacking. I agree with the Authors’ call for data linkage – here we have five data collections that could complement each other and could tell us the bigger (albeit fractured and possibly still incomplete) picture.

Source: http://en.wikipedia.org/wiki/All-terrain_vehicle

 

The Missing Link

13 Jan, 15 | by Barry Pless

In the spring of 1988 I had the honour to serve as the Felton Visiting Professor in Melbourne, Australia. Giving 7 or 8 lectures in 5 days while jet-lagged proved to be a huge ordeal and I don’t think I made a great impression. No, that is not entirely accurate: I was a great hit when I gave an after-dinner speech because most of the audience and I were well ‘into our cups’ (inebriated). In spite of my shortcomings, I left Melbourne with many good ideas.

 

One of these was that we needed to create an injury surveillance system in Canada. My motivation was that this would provide a far more accurate picture of the magnitude of the injury problem we faced. Naively, I thought that when ER data were added to mortality data policy makers would be sufficiently impressed to take action. Although this never happened, the creation of that system (later called the Canadian Hospitals Injury Reporting and Prevention Program (or CHIRPP) may have been one of my most noteworthy accomplishments. It began with m the huge task of persuading the federal deputy health minister all of its importance and the need to support it financially, I also had to persuade all the pediatric ER directors that it was a good idea. Part of what sold the idea to both parties was that this would a collaborative effort between industry, the hospitals, and the government.

 

The industry part involved persuading Hewlett Packard Canada (HP) to donate a desktop computer to each of the 10 children’s hospitals to enable data entry at the ER by a coordinator who was paid by Health Canada. At the time HP was the main supplier of mainframe computers for all children’s hospitals so this was not a tough sell. Basically, CHIRPP involved presenting a form to parents of an injured child to complete while they were waiting to be seen. However, the basic idea that made CHIRPP and it’s Australian predecessor (the National Injury Surveillance and Prevention Program) different – and presumably better then other ER-based systems – was the inclusion of a free text field on the forms where parents were asked to describe “what happened”.

 

As the well-publicized launch date drew nearer, I begin running through a mental checklist of all the items that needed to be in place to make the system work as planned and all that could go wrong. About one week before the actual launch, I discovered that there was, in fact, something I had overlooked: a missing link. Can you guess what it was?

 

Here is a hint: remember that everything hinged on parents filling out one side of the carefully designed reporting forms. It’s true that on the reverse side the treating physician was supposed to enter basic details about the injury and treatment but I was not foolish enough to assume that most physicians would actually do so. We foresaw this problem and arranged for this task to be performed by a paid coordinator based on the medical record. Far more critical was ensuring that parents provided the information we needed, especially the open text field describing ‘what happened’. Generally most parents were given the forms but still something was missing. What was it?

 

If you guessed pencils, you deserve a gold star on your workbook. We had wrongly assumed that most parents had a pencil with them. But we did assume that the ER had enough pencils lying around to fill the need and it never occurred to us that many parents would forget to return them. So we needed a large supply on a regular basis.

 

With little time left I managed to persuade Buros Canada – one of the largest pencil suppliers – to donate large numbers of golf pencils to each hospital each month. They agreed but only if all were sent to one address which turned out to be ‘my’ hospital, the Montreal Children’s. We, in turn, somehow managed to distribute them to all the other hospitals. I honestly don’t know or don’t remember how this problem was solved after I was eased out of my position as CHIRPP’s founder, but somehow it was and the system has survived.

 

Last word: No, in case you were wondering,  providing more accurate (i.e., much larger) numbers has still not persuaded politicians to provide appropriate funding for injury prevention in Canada.

Reference: Mackenzie S, Pless IB. CHIRPP: Canada’s principal injury surveillance program. Inj Prev. Sep 1999; 5(3): 208–213.

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