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Would you choose difficulty accessing health-care?

8 Aug, 17 | by Bridie Scott-Parker

Hopefully you would answer no to the question “Would you choose difficulty accessing health-care?” But that is the reality for Australians who live in the country. A recent survey of country folk regarding their access to health care, mental health and preventative health was undertaken as part of a collaborative project between the Royal Flying Doctor Service, the National Farmers Federation, and the Country Women’s Association of Australia (including Queensland, my home state).

In case you didn’t know, the majority of Australians (70.2%) live in major cities, but these major cities comprise just 0.3% of our land mass. Of our 23.5 million population, approximately 7 million live in remote and rural areas, with half of these living in remote or very remote areas of Australia. While Australia may be the beautiful Sunburnt Country, the poem belies some uniquely-regional experiences, such as through prose including “for flood and fire and famine” and “over the thirsty paddocks“.

So what does health-care look like, and live like, in these areas? The survey of 454 Australians living in remote and regional parts of Australia explored two key perspectives:

  1. the three most important health issues impacting upon their community, and
  2. the three areas in which funding is required to improve community health outcomes.

Most important health issues:

  1. general health access (32.5% of participants), including access to general practitioners, medical specialists, hospitals, diagnostic tests, and allied health services;
  2. mental health problems (12.2%); and
  3. drug and alcohol problems (4.1%).

Other health issues include cancer and cardiovascular health.

Perhaps unsurprisingly, the most important health funding priorities reflect the most important health issues:

  1. general health access (32.2%);
  2. mental health problems (14.6%); and
  3. health prevention and promotion (8.6%).

Other funding priorities include cancer, aged car, and travel and accommodation support for Australians who need to travel outside of their community to access health-related services and support.

While attention has been drawn to the need for better access to health care, and funding has been invested, this report provides the uniquely-Aussie input so critically needed in these injury prevention efforts.

 

 

When cows attack: how dangerous are cattle and how can you stay safe around them? | The Conversation

17 Jul, 17 | by Sheree Bekker

File 20170619 12412 ihxeqe

Curious? Or dangerous?
Shutterstock

[This post is from Carri Westgarth, University of Liverpool and Marie McIntyre, University of Liverpool]

A well-respected retired academic was recently trampled to death by cattle while walking in Oxford. In 2012, my father was hospitalised after being attacked by cows while walking his dogs through a field next to his village. He picked up his dog and was pushed to the floor and trampled before escaping over a wall.

My colleague, Marie, meanwhile, is a keen cross-country runner, and regularly runs with her dog (or is chased) through fields where both dairy and beef cattle graze. These kinds of incident raise questions about the safety of the public near livestock. And we asked these same questions when we conducted research on this very topic.

There are about 9.7m cattle in the UK. Meanwhile, 3.6 billion people annually visit the countryside, with dog walking accounting for 51% of visits. This means that the general public are likely regularly to encounter livestock.

The drive towards healthy living and outdoor pursuits, footpaths crossing farmland, and the introduction of the Countryside and Rights of Way Act 2000 (CROW Act), which promotes public access to “open country”, all encourage countryside activities. At the same time, more and more people grow up in an urban environment, and may not have often experienced livestock. This could lead to more problematic interactions between people and animals.

The facts

So how often do cattle attack people, and what proportion of attacks are fatal? Are there particular risk factors? And what guidance is publicly available on how to behave near cattle?

We searched newspaper reports over two decades, and identified 54 separate attacks by cattle on members of the public out walking. Of these, 24% were fatal. Injuries included fractures from kicking, lacerations, punctured lungs, bruising, black eyes, joint dislocation, nerve damage and unconsciousness.

But how does this compare with official statistics? The Health and Safety Executive (HSE) reports deaths, not attacks. They say that on average four to five people are killed in accidents involving cattle each year, with 74 fatal attacks since 2000. Most were farm workers, but a quarter (24%) of these deaths were members of the public walking on footpaths or commonly used rights of way. The government agency also comments on the under-reporting of this issue, due to a lack of awareness of the need to report a cattle attack as a “workplace” injury.

People may think that bulls are most likely to attack – remember the beginning of Ferdinand the Bull. But while they cause more fatalities among farm workers, both official reports and our work suggest that this is not the case for people out walking.

Where recorded, 91% of HSE reported fatalities on the public were caused by cows with calves; only one death involved a bull, and even this was unproven in court. Of all attacks, we found that 48% were caused by (unspecified) herds, followed by single cows (22%), cows and calves (20%), heifers (7%), and one bull attack (2%). Behavioural research suggests maternal defensive aggression may be behind many attacks.

The dog factor

Does having a dog make a difference? Yes: dogs look like predators, and they are even more threatening to dairy cattle than unfamiliar people. This is reflected in the data: 94% of walkers killed had dogs, and two thirds of all attacks involved dogs. Though our sample numbers were small, we also found evidence suggesting that women were more likely to protect their dogs, while men let them go – the recommended advice, which my dad did not follow.

Beware: cows aren’t keen.
Shutterstock

Does cattle breed make a difference? The HSE says not: the rate of fatalities did not differ for dairy and beef breeds. Both UK industries are highly dominated by certain breeds, such as Holstein and Aberdeen Angus, but farmers report that continental breeds, such as Limousin and Charolais are more highly strung. These are imported into the UK for beef production, and are likely to be more extensively farmed and handled less than dairy cattle, exacerbating any behavioural issues.

So what advice is provided to the public about cattle? The countryside is a great place for exercise, including with dogs, but must be treated with respect. It’s every owner’s duty to make sure that their dog is not a nuisance to farm animals, wildlife or other people.

It’s impractical to expect farmers never to keep cattle where the public can access, but the HSE advises that wherever possible, they should avoid keeping cows and calves in fields with public footpaths, and appropriate signage and protected walkways should be considered.

Cowgate.

They also highlight the main risk factors we mention, further noting that when stressed by the weather, illness or unusual disturbance, cattle can become aggressive too. We found wide variation in countryside guidelines for the public, but many reproduced The Countryside Code.

One area lacking clear guidance is that of dog control near cattle. After a peak of attacks in 2009, the National Farmers Union began to advise keeping dogs on leads around cattle, but releasing them if chased or threatened.

Interestingly, a new sign stating this eventually appeared in the place where my dad was attacked after more incidents had occurred. Fortunately, the only long-term effects for him were a bruised ego during family referrals to “Cowgate” and dogs who shake in fear of cows on TV.

The ConversationBut what is the long-term future for cattle attack research? First, a well-designed, official system to document accidents is required; evidence for risk factors could then be properly assessed, and used to develop better guidance to reduce attacks. In the meantime, remember your dog can run faster than you – let it go.

Carri Westgarth, Research Fellow in Human-Animal Interaction, University of Liverpool and Marie McIntyre, Research Associate Epidemiologist, University of Liverpool

This article was originally published on The Conversation. Read the original article.

6 reasons why students should attend conferences

14 Jun, 17 | by Sheree Bekker

 

[Sheree Bekker] This post is from guest blogger Amy Vassallo. Amy is a PhD candidate at the Faculty of Health Sciences, University of Sydney and Research Assistant at the Prevention Research Collaboration.  As an advocate for women in science she is the student representative on the Franklin Women Peer Advisory Board and curates their monthly e-newsletter. In 2017 Amy is also the student representative on the 13th Australasian Injury Prevention and Safety Promotion Conference Scientific Committee.

 

As research students we are encouraged, and at some institutes required, to attend conferences.  Sure they’re a great way to present your work and research findings, but there is so much more to be gained from conference attendance beyond an 8-10 minute presentation. So what are some of these opportunities and how can you achieve the most out of the few days?

 

  1. The opportunity to present your research (well!)

At the end of the day this still needs to be the first priority for conferencing.  A poorly prepared presentation sticks out like a sore thumb and the audience certainly can tell the difference between a speaker who is nervous (and be very forgiving towards them) and a speaker who is winging it (and be far less forgiving). Be organized and submit your abstract before the deadline, or if you’ve missed out keep an eye out for late breaking abstract opportunities, which often come up in the months just before the conference.  Also consider submitting for a poster presentation in addition to your oral presentation.  Electronic posters are increasingly popular at conferences and are no longer the unfortunate cousin of the oral presentation hidden behind the muffins at afternoon tea.  E-posters are less work to prepare than traditional posters, so feasible to do in addition to an oral, and gives you lots more opportunity for discussion and two-way dialogue about your research.

 

  1. The opportunity to meet other students

Conferences early on in your career can be frightfully intimidating, especially if you’re not there with your supervisor or colleagues from your research institute.  Meeting a group of other students early on can make all the difference.  Many students feel like a fish out of water at their first few conferences (or remember that feeling) and therefore actively want to make new connections. So attend any and all of the social events for students and introduce yourself to people.  You know you will already have a few things in common since you’re at the same conference and experiencing post grad life. Your fellow students may also be your future research collaborators, so these student friendships you build at conferences could be of huge benefit into your future career.

 

  1. The opportunity to meet leaders in your field

Sometimes it’s hard to see the light at the end of the tunnel of your study program, and meeting or listening to inspiring leaders in your field can be just what’s needed to reinvigorate you.  Be prepared and read the conference program and speaker list beforehand.  Is there someone you’re simply desperate to meet one-on-one?  Perhaps a mid-career researcher?  Contact them beforehand to arrange a time to talk, as you shouldn’t expect to bump into everyone at morning tea. But this comes with a warning, make sure you have a clear intention as they will inevitably ask ‘so what is it that you want from me’ and you need to be prepared with a response.

 

  1. The opportunity for careers information and inspiration

Jobs in injury prevention are varied, and that’s one reason why this field is so appealing.  Being at a conference and seeing the breadth of attendees and presentations can provide invaluable advice and inspiration for students about what to expect post-graduation, whether you intend to remain in academia or not.  Have a look in the conference program for any careers focused sessions designed for students and early career researchers.  Conferences are also a good opportunity to find out about professional organizations in your field (like the AIPN for example).  Joining organizations such as these provides you with a network of colleagues, and often a discount on your conference registration or the chance to apply for a student award. Once you get to the conference browse through the sponsor stalls, you never know what inspiration you might find there.

 

  1. The opportunity for skills development and to learn something new

It’s increasingly common for conferences to have satellite skills development workshops either held in the preceding days or over breakfast.  Be sure to check out the conference website beforehand, as these may require an additional registration, but can help make it easier to justify the need for conference travel.  Conferences also provide the opportunity to learn about areas of research you may have never heard of. Try going to some concurrent presentation sessions on a topic you’re less familiar with, you might learn about a different research method or skill that could be innovatively applied to your area.

 

  1. The opportunity to have fun

Go to the side events – the workshops, the pre-conference tours, the conference dinner – just do it!  They always offer a chance to learn something new (related or not to your research) and can help with the nerves and anxiety you might be feeling about more formal conference networking.  Delegates get the chance to let their hair down at these events, and that gives you the chance to see the person behind the research expert, make some friends and have a bit of fun, as a student you deserve it!

 

At this year’s Australian Injury Prevention Network conference, the scientific committee have taken these six goals as the inspiration for the development of an exciting conference program for students.  There will be a focus on posters, a preconference walking tour and informal presentations, a careers panel, a preconference workshop on meta-analysis and a speed networking session just for students designed to help you develop your research pitch. All the details of these events are available on the conference website.

There’s strength in numbers when it comes to injury prevention

11 May, 17 | by Bridie Scott-Parker

This week marks the Fourth UN Global Road Safety Week. As noted on the website, the focus is

on speed and what can be done to address this key risk factor for road traffic deaths and injuries.

Speed contributes to around one-third of all fatal road traffic crashes in high-income countries, and up to half in low- and middle-income countries.

Countries successfully reducing road traffic deaths have done so by prioritizing safety when managing speed. Among the proven strategies to address speed include:

  • Building or modifying roads to include features that calm traffic
  • Establishing speed limits to the function of each road
  • Enforcing speed limits
  • Installing in-vehicle technologies
  • Raising awareness about the dangers of speeding.

The Fourth UN Global Road Safety Week seeks to increase understanding of the dangers of speed and generate action on measures to address speed, thereby saving lives on the roads.

One of the ways that injury prevention researchers – such as myself – can increase their capacity for influence is working with others who also have the capacity for influence. Regular readers of the blog will recognise my repeated recommendation to connect, collaborate, and achieve; indeed I’ve often featured my perspectives regarding the many and varied benefits that arise from such actions.

Today, for something a little different, I am delighted to feature a blog written by my colleague, Ms Julia Carter, the Writer and Content Marketing Specialist at Youi Insurance, as she shares some thoughts regarding working with an injury prevention researcher:

 

At Youi, we know there’s a huge gap in the car insurance market. Insurers are providing cover for when things go wrong on the road, but what are we actually doing to prevent those things from happening?

Knowledge is Power

We believe we have a responsibility as insurers to help protect our customers the best we can, and not just by offering them cover for a range of insured events, but by equipping them with tools and resources that help avoid those events in the first place.

Engage an Expert

In addition to regularly writing articles about road safety and publishing them on our “On The Road” blog, we have partnered with Dr. Bridie Scott-Parker to focus on injury prevention. Dr. Bridie’s expertise perfectly complements our content mission to raise awareness for road safety. We are currently finalizing production for a new VLOG featuring Dr Bridie’s research, which we hope will engage and inspire various road users to commit to road safety.

Be Seen to be Heard

Of course sometimes the easiest way to get people to listen is to speak directly to them. That’s why we recently hosted a #SlowDownDay as part of the 4th annual United Nations Global Road Safety Week. The event encouraged our staff to take a few minutes out of their busy day to slow down, grab a snack and learn about road safety from experts in the field, including Dr. Bridie and the Queensland Fire & Emergency Services. We also invited our partners from the Sunshine Coast Animal Refuge to share some tips on preventing animal collisions, and Automotive Service Centres (ABS) discussed the importance of regular car servicing and brake check-ups to ensure safe driving.

Strength in Skills & Numbers

One thing we’ve learned since taking this more robust approach to road safety awareness is that people want to stay safe on the roads. Everyone’s been touched by a road collision in some way or another, and we all agree that we need to do our part in making the roads a safer place for everyone. That said, we have found that getting people to take the time to read or watch content about road safety requires a variety of skills. In this day and age of social media and information overload, there is so much content online that most of it just gets lost. Having someone as enthusiastic and passionate as Dr. Bridie deliver road safety education is instrumental, but we also need to host that content in the right place, boost it through the right channels, and throw all of our resources behind it to ensure the message gets across.

 

We are extremely excited about what the future of this partnership holds and its potential to bring Dr. Bridie’s research to a wider audience through a strategic content marketing approach. We encourage all businesses and individuals to seek out local road safety authorities and create similar partnerships, because when it comes to injury prevention, there is strength in numbers.

 

 

Kathrin Steffen | People in Injury Prevention

24 Apr, 17 | by Sheree Bekker

[Sheree Bekker] In the lead up to the 13th Australasian Injury Prevention and Safety Promotion Conference, I invited keynote speaker Dr Kathrin Steffen to answer a few questions for our blog.

Kathrin Steffen is a senior researcher from the Oslo Sports Trauma Research Center. Kathrin also serves as a research assistant at the Department of Medical & Scientific Activities in the International Olympic Committee (IOC). She is the assistant editor for the 4 annual issues of the IOC supported journal British Journal of Sports Medicine Injury Prevention & Health Protection, in addition to being involved in other IOC driven research projects.

1. Tell us about your training and role in injury prevention
After finishing my Masters studies in Germany (German Sports University in Cologne), in the field of prevention and management of noncommunicable diseases, I moved on to Norway and the Norwegian School of Sport Sciences and the Oslo Sports Trauma Research Center, where I earned a PhD in sports injury epidemiology. Another positive addition to my development was a 1-yr post-doc exchange with the group of Prof Carolyn Emery at the Sports Injury Prevention Research Centre in Calgary. The value of an intercultural exchange cannot be stressed enough.

2. What is your research focused on, and what do you see as the issues currently facing injury prevention?
Besides my research interests in injury epidemiology and prevention in the broader sports community, I am the project leader for national and international multimedia projects to disseminate knowledge in sports medicine. At present, I am working full time with the content management for a multi-lingual “SKADEFRI/GET SET – webpage/mobile application” on injuries and injury prevention in Olympic sports.
One of the biggest challenges in our field of injury prevention seems to be is to convince people that “the pill” is good for them. As one example, we have evidence enough that structured conditioning training/neuromuscular training, focussing on sport specific injury types, will reduce the risk of injury providing training is done regularly. However, we still see a high number of injuries in the field. Having developed digital tools in corporation with coaches, athletes, and sports federations to facilitate usage of prevention exercises, we still don’t see the desired adoption of these tools. The knowledge doesn’t seem to be translated well enough, and mechanisms on how best to translate are not optimally understood.

3. How does your research Take Action?
The Oslo Sports Trauma Research Center has a special focus on the young athlete, though many of the research projects are done in elite sports. Much of the knowledge gained from elite athletes can easily be transferred to, and shared with, recreational sports. Also, we have a close contact to the National Sports Federations, and we collaborate on developing injury prevention materials to be mandatory in the coach education system. The development of multimedia tools (web and apps) helps to facilitate the usage of existing knowledge in the field. However, the validation of these tools still remains a challenge in Norway.

4. What can emerging researchers learn from you?
Don´t be afraid of leaving your group and go abroad to further develop personal and research skills.

5. What are you looking forward to when coming to Ballarat?
The ACRISP-group with their head, Prof Caroline Finch, are world leading in the field of implementation research. I’m looking forward to the exchange experiences and learning from each other, through expected cultural differences and similarities.

 

The call for abstracts for the 13th Australasian Injury Prevention and Safety Promotion Conference is open until the end of April 2017. 

Happy International Women’s Day 2017!

8 Mar, 17 | by Bridie Scott-Parker

Today is International Women’s Day 2017, and while each and every one of us has our own experiences relating to this year’s theme, I thought I would share with you my own recent reflections on how I have been Bold for Change. I was honoured to share my experiences at the Graduate Women Queensland Sunshine Coast Branch International Women’s Day Breakfast last Saturday, and in preparing for this event – as any good researcher would proceed – I leapt into my homework activity and asked Google for definitions of “bold”. While some were rather risqué, I found some definitions with which I sensed a strong affiliation, and I shared some of my good, and less-good, life experiences around these definitions.

  1. Confident and courageous, daring and brave. Regular readers of the blog, and anyone who knows me beyond my peer-reviewed publications, will know that I have had more than my share of physical challenges. It never ceases to surprise me that, on a weekly basis at a minimum, I encounter someone who is surprised to see me working, mothering, contributing to my local community or the global community more generally. Yes, staying at home and resting all day would definitely be the easy thing to do, but I do not seem have the gene that allows me to do this! I was also brought up by a confident and courageous, daring and brave mum (and dad) who encouraged me from the cradle to leave my small farming community and move to the capital city and gain a degree, something girls are NOT supposed to do. I see my own daughter being confident and courageous, daring and brave, doing the same, and it reinforces that I (and my mum) have done the right thing, and I couldn’t be more proud of both of them.
  2. Not hesitating in the face of rebuff, or to break rules of propriety. Kudos again is needed for my mum (and dad) for raising a strong-willed (I prefer ‘tenacious and resilient’, while my husband is more likely to use ‘stubborn and pig-headed’) daughter, who is living the family motto of leave-the-world-better. Sometimes this means that there will be rebuff, and sometimes this means breaking rules of propriety. So be it. I am confident and courageous, daring and brave, and I WILL leave the world better.
  3. Not afraid to speak up for what she believes, even to people with more power.  Change will not happen unless people – women! – who are confident and courageous, daring and brave, and who do not hesitate in the face of rebuff and do not hesitate to break the rules of propriety are not afraid to speak up for what they believe. Others may have more power, but to me that means that others can join me in tireless quest to prevent injury among our most precious, our children. I have worked very hard through my studies, and my life post-PhD, and through these efforts (and experimentation with my own children!) have developed, implemented, and evaluated some highly innovative projects. Change not only requires bold thinking, but bold actions, so I walk-the-walk, not just talk-the-talk.
  4. Not afraid of difficult situations. Every day is an opportunity to learn: you might learn something about yourself, about another, or about something as lovely as a pet cat or dog. I am a big fan of reframing and looking at the positive of any situation, no matter how dire. A difficult situation is a fantastic opportunity to learn, and not only can you learn to manage difficult situations, you will also learn from these difficult situations, by being confident and courageous, daring and brave, and speaking up. It’s important however to remember to listen, and to talk with, not just talk at or be talked at. Everyone likes to be talked with 🙂
  5. Willingness to take risks. I am willing to take risks. I have been in a medication trial, and being number 23 in a world’s first double-blind study was scary, particularly when there was a massive list of potential side-effects, including death, and I had two small children, a husband and a mortgage. I have also taken many risks during my studies and in my post-doctoral life by treading a less-conventional path, and indeed I prefer to live life generally as an open book. Life is much simpler that way. Doing this has required me to be confident and courageous, daring and brave; to speak up; to not be afraid of difficult situations; and to be willing to take risks. I take educated risks, however, and use all my nous, research skills, and social supports to take every step to help these risks translate into injury prevention, whatever my endeavour.
  6. A final message?  Whether you are a woman on International Women’s Day, or someone who shares the planet with a woman on International Women’s Day (or indeed any other day), you can make a difference and you can prevent injury, by being bold for change 🙂

Pondering the peanutabout…..

5 Jan, 17 | by Bridie Scott-Parker

I read the StreetsBlogUSA post Study: Diagonal Intersections are Especially Dangerous for Cyclists today with great interest, for a number of reasons that I thought I would share with you.

Firstly, there is no doubt that cyclists are a vulnerable road user group, and that particular segments of road are more problematic for cyclists. The research cited in the post pertains to an Injury Prevention publication which examined, in-depth, police reports of 300 car-cyclist crashes in the New York city area , and the police templates to record crash-pertinent information across the US. Innovative research which approaches a known problem from novel perspectives helps to provide additional pieces for the jigsaw puzzle that we seek to solve, and this research was an intriguing read indeed.

Secondly, the research revealed that some road configurations appeared to increase crash risk (i.e., we want to reconfigure these roads), and that the safest option in the most problematic circumstances was to separate the motor vehicle from the vulnerable cyclist. The ‘solution’ for cyclist safety can be a highly contentious issue, particularly here in Australia in which the motor vehicle has traditionally – through necessity – dominated our vast landscape, and as health and other benefits become apparent, cycling is gaining traction. Indeed, Cadel Evans, arguably Australia’s most celebrated cyclist, has tried to bring clarity to this divisive issue; stating that

I don’t think we should separate the two, because most people who ride a bike also have a car. In the end, they’re public roads for everyone. It’s a privilege to use roads; not a right.

 We have to respect everyone who’s using them, whether they’re driving a car, bus, tractor or truck, or riding a bike or are a pedestrian. We have to respect each other’s privilege and safety.”

in response to the question “What do you say to drivers who think cyclists don’t belong on the road?

Thirdly, the innovative solution of the peanutabout helps speak to ideas beyond the cyclist themselves – this is consistent with systems thinking which argues that safety (in this case, cyclist safety) emerges from a complex web of actions and interactions among a breadth of stakeholders who play a role in the larger safety system (e.g., in the case of my own research interests, an application of systems thinking in the young driver road safety). Given we are more than half way through the Decade of Action for Road Safety, and in the case of Australia, our road toll returned to an upward trajectory in 2016 after many years of a downward trajectory, such innovative thinking is critical.

Fourthly, the researchers noted that the templates used by police to record crash-pertinent information did not provide adequate details regarding the crash circumstances. Unfortunately this is not an uncommon problem, and again one that I have come across in my own research endeavours. If we are to effectively prevent injury, we need as much contextual and other information regarding the incident contributing to the injury.

Fifthly, while the peanutabout appears to be an ideal solution to the critical issues identified for the area noted, I am mindful that drivers do not always ‘cope well’ with complex infrastructure such as roundabouts. As a researcher within the realm of young driver road safety, and the mother of teen with the learner licence which requires full supervision whenever she is behind the wheel, Learner drivers often tell me that they ‘freak out’ when they come to a roundabout, and it is not actually round! According to Learners, roundabouts must be round, while oval roundabouts and others shaped as a parallelogram should be called something different. Hmmmm, on reflection, maybe Learners will be okay with a ‘peanutabout’…..

Finally, I paused to reflect on the safety implications for motorcyclists – another vulnerable road user group. While traversing a roundabout on his Harley Davidson last year, a colleague was driven over by a driver behind the wheel of 4WD, texting, who reported that she had checked the roundabout for vehicles before entering, and that she did not see – or hear – my colleague already on the roundabout (and thus he had right of way) until her front right tyre was on top of his leg and his motorbike. Thankfully he has managed to retain his leg, however he has had multiple operations, requires additional surgery, and will be scarred for life and never walk without support again. My colleague is the first to acknowledge that motorcyclists sometimes deliberately place themselves in danger through their riding behaviours – himself included – however we both eagerly await any intervention that will increase motorcycle safety when traversing complex infrastructure such as roundabouts.

Safe Travels – or Tampere and back again (and everything in between)

23 Oct, 16 | by Sheree Bekker

1

[SB] Our guest blogger is Russ Milner – reporting on his experiences at the recent Safety conference (follow him on Twitter @RussMilner)

[RM] I was fortunate enough to win the inaugural Australian Injury Prevention Network (AIPN) Travel Subsidy to support my attendance at Safety 2016, the 12th World Conference on Injury Prevention and Safety Promotion in Tampere, Finland.

As delighted as I was to receive this news, I soon realised that arranging the various approvals and logistics to allow my attendance was a pressing issue that I had minimal control over. After a couple of anxious weeks, I had every box ticked and a suitcase to pack – but what to pack? I wasn’t familiar with Tampere prior to the conference, but it was described to me as (close to) “the home of Father Christmas”, and we all know Santa dresses for the cold. The conference information gave the vague dress code of “smart casual”, while other people suggested I invest in thermal underwear. I packed as best I could to include casual wear, warm options, and suitable clothes to represent both the AIPN and my employer, the Department of Health Western Australia, at a World Conference of international experts in my profession.

The journey to Tampere, in a nutshell, involved 18 hours in the air, 11 hours in airports, 30 minutes on a bus, and a couple of short walks. Teleporters* need to become a reality sooner rather than later. 30 hours in total, but hey, that time had to be spent somewhere, and I had plenty of time to peruse the comprehensive conference program. Said program was filled with plenary speakers, state of the art sessions, parallel sessions, pitching sessions, poster displays, poster walks, business meetings, side events, and social events—well and truly jam-packed with content. As much fun as I had in transit, all good things must come to an end, and finally I reached my accommodation. With an evening free I stretched my legs with a short walk, freshened up, unpacked, and got ready for a busy four-day conference.

Sunday

According to the conference program, the official opening ceremony started at 15:00 on the Sunday, but keen beans had the opportunity to attend pre-conference sessions from 10:00. For better or for worse, one of these sessions was entitled ‘Achieving population level changes in health: A dialogue on pathways to progress’ piquing my interest enough to make me an aforementioned keen bean. As chance would have it, I entered the impressive Tampere Hall (“Tampere-talo”, to the locals) 20 metres behind a colleague from Perth. It’s a small world after all. An interesting series of presentations and group discussions quickly revealed that across the globe, many issues and challenges are shared by injury prevention and safety promotion (IPSP) practitioners. It was comforting to realise that we’re all in this together, yet concerning that we haven’t found a way to solve the problems altogether. I mustered the courage to take the roving microphone in this session and reflect both on what I’d heard during the session and my experiences from back home in Perth. Thankfully, my comments were praised by the moderator and generated some further discussion from other interested delegates in the room. We were off and running.

The afternoon rolled around and we were officially welcomed to Tampere the city and the conference itself. Luminaries from the Government of Finland, the World Health Organization (WHO), Finland’s National Institute for Health and Welfare, and the International Organizing Committee all made us very comfortable while stressing the importance of IPSP. This welcome was capped by a video message from Michael Bloomberg who in August 2016 was named the WHO Global Ambassador for Noncommunicable Diseases, a role Mr Bloomberg strongly emphasised included injuries. This is a fantastic coup for the IPSP community, to have someone of such prominence as our Global Ambassador.

Some light entertainment followed, which included a string trio performing classical music, before a series of circus acts of contortion, corde-lisse and jump rope – all performed safely to the relief of the audience!

The first plenary session was scheduled to run from 17:00 to 18:30 on a Sunday – a curious timeslot for those of us used to Australian customs, but they were as captivating as they were entertaining – a great way to spend a Sunday evening, truly! Professor Adnan Hyder kicked off with a passionate presentation on what remains unacceptable across the field of IPSP, providing seven suggestions for turning evidence into policy and practice, and challenging delegates to take one thing from the conference they could implement after returning home. The session was concluded in theatrical fashion by Australia’s own Dr Dale Hanson, who proved to be a multitalented performer while brilliantly performing a one-man show on the 1854 cholera outbreak in London – a case study I vividly remember from Public Health 101 from my university days, albeit not so well presented.

The Sunday program concluded with a get together reception hosted by Bloomberg Philanthropies, providing the first real opportunity to mingle and meet other delegates over canapés and drinks. Delegates compared travel stories and commented on how enjoyable the opening day of the conference was. The scene was set for an engaging few days to come.

Monday

If I’m honest, Monday was a bit of a blur. The conference program ran from 08:30 until 18:00, followed by a welcome reception that started at 19:00. As I walked back to my hotel to freshen up in the hour between events, I reflected on the fact I had seen 36 world-class presentations throughout the day, while countless** others occurred in other rooms during parallel sessions. Not only that, but I’d also browsed the many posters on display during a much-needed coffee break, only adding to the sea of content I found myself swimming in. Twitter also played a part in keeping highlights trickling through under the hashtag #safety2016fin. As such, it’s a fruitless task to try and summarise the content into a paragraph or two. However, for the record, I attended sessions focussed on Indigenous safety; Falls; Traffic safety; Child and adolescent safety; and Strategies, legislation action plans and policies. Thankfully, the BMJ Injury Prevention, October 2016, Volume 22, Issue 5 contains abstracts on every presentation from the conference, a useful resource into the future.

Of note, it was nice to see Australia well represented throughout the day, with 9 of the 36 presentations I saw coming from ‘back home’, including one on the falls prevention grants program delivered by the Injury Control Council of WA in partnership with my team at the Department of Health WA. I was both pleased and proud to note how well our presentations stacked up against those from other countries on the world stage. Throughout the day I tried to actively tweet [see Twitter timeline] a few highlights as they caught my attention. Based on the amount of others doing the same, and taking photos of slides rather than scribbling notes, it seems modern technology has redefined how notes are taken these days, rather than the traditional pad-and-pen method.

Needless to say, I was pretty happy when my head hit the pillow on Monday night.

Tuesday

Tuesday was another big day, with lots of content and a couple of social events. The plenary session for the day focussed on Safety and Sustainable Development, before parallel sessions where I jumped from Child safety to Drowning and water safety – both topic areas I am involved in back home. It was great to see a presentation from Kidsafe WA on their Child Safety Online Demonstration House, another initiative delivered in partnership with my team. Continuing the theme of strong linkages to the WA setting, I attended a state of the art session on Safety in rural and remote areas in the stunning Maestro theatre of Tampere Hall. A morning and early afternoon well spent with some great presentations to ponder, and more importantly, names and faces with experience to share.

Those of us who were active in the Twittersphere took the opportunity to meet up in person during the afternoon coffee break, which was great to put a physical face to a digital name. From memory, in the quick half hour I met four Finns, three Canadians, one Australian and one Estonian. No partridge in a pear tree, however.

The later sessions included presentations on Technology – solutions and applications for safety, and Consumer Safety. The first presentation highlighted another partnership between the Department of Health WA and the Injury Control Council of WA—the Know Injury knowledge hub (http://knowinjury.org.au/), in particular the CONNECT.ed networking program (http://knowinjury.org.au/connect/connected/)—both links I would encourage readers of this report to click.

The great majority of delegates then boarded a convoy of buses and headed out to Tampereen Messu- ja Urheilukeskus at Ilmailunkatu 20 (ahem), or “Star Arena”, as it was described at the English-speaking conference. This was the site for the conference dinner, where many a good time was had. I joined an Australian and New Zealand contingent and made a table with a group of Finnish locals who made us very welcome. It was only at this point that I gained an appreciation of the fact that for the Finns, English was most certainly a ‘second’ language that they had to concentrate to speak fluently, and importantly, understand the various accents of their global guests. Despite their admitted limitations, one could be forgiven for thinking they spoke English as well as we do. They were fantastic hosts. They were also fantastic dancers, hitting the dance floor the moment the band played their opening licks and stayed on their feet (no pun intended, well, maybe a little) until the last song had been sung.

Wednesday

Now, this was my first world conference, but I was told by multiple reliable sources that the early morning session after the conference dinner would be the least well attended of the program. I can confirm that to be the case to any readers who may be awaiting their first conference (Bangkok in 2018, by the way). Regardless, those who did muster the energy early on the fourth and final day had an early choice between six different parallel sessions or 22(!) different poster walks. Did I mention it was a busy conference?

The late morning session offered the last of the state of the art sessions, I selected the Child and adolescent safety option. Stoically forgoing the scheduled lunch break, I instead joined a World Health Organization-hosted business meeting that I had been graciously invited to over dinner the previous night. Entitled, Implementing the Regional Action Plan for the prevention of violence and injuries in the Western Pacific (2016-2020), the meeting seemed to pose the question of “how can the injury prevention sector across the Western Pacific region better work together?”. Hopefully, the Know Injury knowledge hub and CONNECT.ed program I hyperlinked above can contribute to the solution.

The final afternoon included a plenary session on Solutions for the future and a Closing ceremony that included the awarding of International Safety Media Awards and proclamation of the Tampere Declaration. Finally, the baton was passed to Bangkok for the 13th World Conference on Injury Prevention and Safety Promotion, and delegates were able to say their goodbyes and prepare for their journey home. AIPN President, Associate Professor Kerrianne Watt and I posed for a photo to mark the occasion.

Summary

So, after four days of a conference that attracted 1,200 delegates from 80+ countries, and produced 1,000+ presentations and 5,000+ tweets, how can I summarise a few key take home messages for readers of this report? A tough task indeed. Hopefully the following points are of value:

  • Networks of people are important. There is so much to be shared and learned across the IPSP portfolio, yet too often we are ‘siloed’ by geography or topic area.
  • IPSP issues across the globe are very similar. The contexts and settings may change, but the key topics largely stay the same. Programs in other countries may be modified and adapted for your local context.
  • Research, Context and Practice are equally important components of a successful solution. The best methods, with the best fit, and the best practice.
  • The United Nations’ Sustainable Development Goals were commonly referenced by plenary speakers. Available here.
  • We know more than we give ourselves credit for. Many effective prevention strategies are already well understood by IPSP professionals. The key is to translate this to the communities we live in. Share, communicate, network.
  • Information, tools and resources are available. We need to share and promote these to each other and the community.

I would like to sincerely thank the AIPN for the funding and opportunity to attend Safety 2016. Thanks also to the Department of Health WA for supporting my attendance. It was an experience I greatly enjoyed, and will no doubt provide benefit to my future endeavours to prevent injury in Western Australia. Kiitos!

*In typing this, Microsoft Word informed me that ‘Teleporters’ is not a word. Not yet, Microsoft. Not yet…

**137, I counted for the sake of this report.

The Lancet Series on Urban Design, Transport and Health: cities planned for humans rather than cars

19 Oct, 16 | by Sheree Bekker

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“Worldwide, the majority of people already live in cities and by 2050, it is estimated that 75% of 10 billion people have cities as an important social determinant of health. Air pollution, physical inactivity, noise, social isolation, unhealthy diets, and exposure to crime play a very important part in the non-communicable disease burden. This 3-part Series explores how integrated multisector city planning, including urban design and transport planning, can be used as an important and currently underused force for health and wellbeing within the framework of the Sustainable Development Goals in both high-income countries and low-income and middle-income countries” Executive Summary

The Lancet recently launched a new series on Urban Design, Transport and Health. Of interest to Injury Prevention readers will be the outcomes around the United Nations Sustainable Development Goal 3: good health and wellbeing – of which this series focuses on targets around the reduction of road trauma:

“The health impacts we looked at were those that had a direct relationship to the transport system and and our urban form, and we also looked at what I call the byproduct of our motorised society – which is road injury and deaths” ~ Mark Stevenson

In particular, the second paper in the series – Land use, transport, and population health: estimating the health benefits of compact cities – quantifies the relationship between land use, urban design, population density and transport systems, and the public health impact thereof in 6 international cities (Melbourne, London, Boston, Sao Paulo, Delhi, and Copenhagen).

A central recommendation of this research, within the framework of the UN Sustainable Development Goals, is for ‘compact cities’ in which people are able to live and work in neighborhoods with safe infrastructure that makes everyday active transport possible. In other words: cities planned for humans rather than cars. The key benefits of such compact cities are two-fold: a reduction in road trauma due to fewer cars being on the road, and and increase in physical activity due to more (safe) active transport options.

Compact cities and active transport = an injury prevention/public health win-win.

Read more:

Urban Design, Transport and Health | The Lancet

Cities for Healthier Lives | The University of Melbourne Pursuit

Life post-injury, aka preventing further injury

20 Sep, 16 | by Bridie Scott-Parker

While we as injury-prevention professionals, practitioners and policy-makers work tirelessly to prevent injury, the reality is – never more evident than at the Safety 2016 conference underway as I type in Tampere, Finland – that

“Beyond deaths tens of millions of people suffer injuries that lead to hospitalization, emergency department visits, and treatment by general practitioners. Many are left with temporary or permanent disabilities….”  Etienne Krug, MD, MPH, Director, Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization.

Moreover, diseases such as diabetes, heart disease, cancer, mental illness, and respiratory conditions to name a few, arguably lead to injury and disability, therefore we must continue in our efforts to reduce the incidence of disease wherever possible.

Now, to the other side of the coin…..

If you are one of the many lucky people out there who has never had to live with an injury (whether it was temporary or permanent) or a disease (particularly one that you have incurred through no fault of your own), try being the one living with that injury or that disease. Try then to prevent incurring further injury. As a person who has tango-ed for many years with the she-beast Multiple Sclerosis (MS), I can tell you it is pretty darn hard. Having recently visited our developed-nation’s capital, Canberra, for a conference, I was dismayed to encounter  injury-prevention issues every day. Two examples:

Example 1. I can no longer traverse stairs without a great deal of difficulty (and hilarity as my Students and/or Research Assistants are required to act as my ‘squishies’ by forming a human beanbag around me in case I fall during the journey up or down), and while there was an elevator that was available to use in an adjoining building (a casino), despite being advised by building b (my hotel) that I could use this elevator during casino hours, casino security advised me I was unable to use it as I was not a casino-patron. Despite all of my conference colleagues traversing the steps within 30 feet of the elevator, I had to leave the building to repeat my early morning trek of a (now uphill) ramp, road, broken paving (again uphill), footpath, and construction zone, using my walking stick and my wheelie bag to keep me upright, with an overall distance that was at least 3 times that of my able-bodied colleagues. I fall quite regularly and I am always very careful in how I land as if I lose the use of one or more arms through an injury my capacity to care for myself, let alone work, be a mother etc, will be greatly impacted upon. Managing fatigue is very important for staying upright, and having a finite pool of energy which is impacted upon by MS, this is not the way to prevent further physical injury. How about offering assistance or solutions that are not only realistic but also allow me some independence? I am not my disease or my disability.

 

Broken paving which strikes fear in the heart of anyone who is a falls' risk

Broken paving which strikes fear in the heart of anyone who is a falls’ risk

 

Example 2. There was a delay with our return flight home, as there often is as we leave our nation’s capital, and as I have mobility issues I need assistance to board the plane. My friend and colleague was kind enough to assist me through this process, and we were ‘bumped’ to the head of the queue so that we could get seated with as little difficulty as possible. Unfortunately as we traveled down the ramp to the plane a fellow traveler yelled out ‘So what did you do to yourself?’, to which I stopped, steadied myself with the handrail and turned around before replying ‘I didn’t do anything to myself, I have multiple sclerosis’. Understandably the gentleman was very apologetic, however it can be very confronting to have complete strangers ask you why you walk the way you do, or you use a stick, or you are in a wheelchair. Some days it just rolls right off me, but other days when your reserves might be low, you might already have had a dozen people ask you, and you have managed to get through airport security with a walking stick (no easy feat itself!), you just feel like saying ‘Give me a break, did I ask if you have hemorrhoids?’ I am pretty resilient – indeed I could be the poster child for resilience and tenacity, despite my husband saying it is just plain pigheadedness and stubbornness – but even I reach my limits. We are already coping with a pretty full load, 24 hours a day, 7 days a week, with no break EVER. Someone stronger may not be able to cope with the constant questioning. This is not the way to prevent further mental injury. Again, how about offering assistance or solutions that are not only realistic but also allow me some independence? I am not my disease or my disability.

Here in Queensland last week was Disability Action Week, with the aim of empowering people with disability, raising awareness of disability issues, and improving access and inclusion throughout the wider community. This year has been pretty tricky. Unfortunately I had a pretty horrid weekend before the DAW, and the doctors at our local hospital were just wonderful despite struggling with my collapsing veins.

You can see the result of two collapsed veins during failed IV insertion, 10 days later (you can’t see the bruise from the one that succeeded, on the back of my hand)

The result of two collapsed veins during IV insertion, 10 days later

 

I had intended to blog last week about the exciting Rio 2016 Paralympic Games and what a great chance for people to see disability and disease through a different lens. Instead I spent much of last week struggling to manage new medication, work, being a mum/wife/daughter/friend, and independence as friends and family acted as chauffeurs and gophers, nurses and hug-machines.

Anyone who knows me knows that I am a do-er. Get in there and get it done! As the saying goes, if you want something done, ask a busy person 🙂 I don’t usually share about how tricky it can be living with MS ALL DAY EVERY DAY, but this seemed the ideal time to give some tiny insight into what it is like to further prevent injury when you already have an injury, which is what we also need to be about if we are to make injury prevention progress.

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