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Offbeat

Injury prevention and Indigenous Australians

11 Apr, 15 | by Bridie Scott-Parker

Yesterday I came across a report which estimated the fatal burden of disease and injury for Indigenous Australians. Included were estimates of the magnitude of the fatal burden ‘gap’ between Indigenous and non-Indigenous Australians.

The Burden of Disease Study: Fatal burden of disease in Aboriginal and Torres Strait Islander people 2010 report includes fatal burden calculations in terms of years of life lost (YLL). Noteworthy findings include

Injuries and cardiovascular diseases contributed the most fatal burden for Indigenous Australians (22% and 21% respectively), followed by cancer (17%), infant and congenital conditions (10%), gastrointestinal diseases (6%) and endocrine disorders (which includes diabetes) (5%). These disease groups accounted for 82% of all Indigenous YLL in 2010.

Deaths in infants contributed the most to Indigenous YLL. The fatal burden in Indigenous infants was largely due to infant and congenital conditions, which includes causes such as pre-term birth complications, birth trauma and congenital defects.

‘Injuries were the leading cause of fatal burden among Indigenous persons aged 1- 34, after which cardiovascular diseases and cancer were most prominent,’ said Australian Institute of Health and Welfare spokesperson Dr Fadwa Al-Yaman.

YLL rates for injuries and cardiovascular diseases were almost 3 times as high in the Indigenous population.

Clearly we need to reduce the injury-related burden for all persons, and for indigenous persons in particular. It is important that we use this information to more forward to achieve that outcome – but, just how do we do this? What are the next steps? How do we start the ball rolling, and then maintain its momentum? I would argue that this is the greatest challenge facing injury prevention researchers and practitioners around the world.

World Health Day 2015

7 Apr, 15 | by Bridie Scott-Parker

In case you didn’t know, today, the 7th of April, is World Health Day 2015. As can be read on the World Health Organization website, WHO hopes to highlight

the challenges and opportunities associated with food safety under the slogan “From farm to plate, make food safe.”

“Food production has been industrialized and its trade and distribution have been globalized,” says WHO Director-General Dr Margaret Chan. “These changes introduce multiple new opportunities for food to become contaminated with harmful bacteria, viruses, parasites, or chemicals.”

Dr Chan adds: “A local food safety problem can rapidly become an international emergency. Investigation of an outbreak of foodborne disease is vastly more complicated when a single plate or package of food contains ingredients from multiple countries.”

My husband experienced first hand the consequences of poor food handling practices, experiencing severe gastrointestinal upset which started showing itself half way through a 16-hour cross-Pacific flight. The extremely unpleasant side-effects lasted for several days, and he will not be eating airport lounge fast-food any time soon!

I myself had a number of blood tests earlier this year after persistent ill health – thankfully I returned negative results, unlike other Australians who similarly had eaten contaminated berries imported from overseas. This latest scare has prompted a call for clearer packaging, and improved safety standards in Australia and overseas.

Our immediate experiences cannot compare with those of individuals who have lost their lives due to foodborne illnesses, however. The WHO has released its preliminary findings regarding the global burden of foodborne diseases, with additional findings expected later this year. I look forward to seeing further results in this important injury prevention domain.

 

 

Drowning in injury prevention

6 Apr, 15 | by Bridie Scott-Parker

Living in the Sunshine State, water safety has always been important to our family. I remember learning how to rescue someone, and how to swim safely out of an ocean rip, as a young child. I grew up in a farming community, and my brothers and I always knew if we went near the dam we would be in for it. I have also seen how resuscitation after drowning may not always the best option.

Given it is school holidays, and given how popular our state is at this time of year, unfortunately we have seen some near misses – thank goodness they reached these struggling swimmers in time. The difference between drowning and surviving can be just seconds.

Children are particularly vulnerable – during the last couple of weeks, a 15-month old drowned in the family pool; a four-year old boy drowned in the neighbour’s pool; a two-year-old boy drowned in the family dam…. figures showed five drownings in pools, seven in dams and two in waterways among children under eight since July 2014.

As an injury prevention researcher I firmly believe in preventing drownings and near-miss drownings is the best course of action we can take, and any research findings which help us take a holistic approach to preventing drownings spark my interest. In November 2014, the World Health Organization released its first Global report on drowning: preventing a leading killer. with the World Conference on Drowning Prevention to be held in Malaysia in November. The April edition of Injury Prevention features a paper by Karimi, Beiki, and Mohammadi, highlighting the increased drowning risk for boys with a foreign background; an article by Tian, Shaw, Zack, Kobau, Dyckstra, and Covington in the the March edition of Epilepsy & Behavior highlighting the increased risk of death due to drowning for children and young adults with epilepsy; and the February edition of PLoS One featuring an article by Wallis, Watt, Franklin, Nixon, and Kimble highlighting the considerable burden of drowning and near-drowning among children aged 0-19 years in Queensland.

Clearly we have much progress to make, and publishing research findings such as these are vital to prevent water-related deaths in persons of all ages.

 

 

 

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

082

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.

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