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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 🙂

Take Action for Injury Prevention 2017

27 Feb, 17 | by Sheree Bekker

In his closing remarks to the 2016 World Safety conference, Professor Adnan Hyder encouraged delegates to “take action.” These words also weave through the Tampere Declaration which encourages a global commitment for stronger injury and violence prevention by integrating injury and violence prevention into other health and safety advocacy platforms.

The Australian Injury Prevention Network (AIPN), Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP) and Federation University Australia, are pleased to be hosting the 13th Australasian Injury Prevention and Safety Promotion Conference, to be held at The Mercure Hotel and Convention Centre, Ballarat, Victoria, 13 – 15 November 2017.

Take Action is the theme of the 2017 Australasian Injury Prevention and Safety Promotion Conference.

The conference will celebrate five ways in which we can Take Action:

  • Systems for safer cities and stronger communities
  • Injury prevention through the arts
  • Advancing approaches to injury and violence prevention
  • Applying data in policy, planning and research
  • Understanding outcomes and experiences

Some of these areas have been the topic of recent blog posts here on the Injury Prevention blog. Injury Prevention through the Arts was discussed in Meet Graham and Almost Impossible Cancer Spaghetti: The intersection between injury prevention and the arts, and Systems for Safer Cities and Stronger Communities was highlighted in The Lancet Series on Urban Design, Transport and Health: cities planned for humans rather than cars.

Presentations from all fields of injury and safety promotion will be included in the program (child and family safety, road and transport safety, falls and ageing, water safety and drowning, burns prevention, sports injury prevention, workplace safety, injury amongst Aboriginal and Torres Strait Islander communities, intentional injury, trauma outcomes and registries, plus many more…)

We’ll be outlining more about the ideas to Take Action in the lead up to the conference, as well as profiling our keynote and invited speakers.

For now, we encourage everyone to Take Action on their abstracts – submissions close 11th April 2017.

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.

Meet Graham and Almost Impossible Cancer Spaghetti: The intersection between injury prevention and the arts

22 Nov, 16 | by Sheree Bekker

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“The artist is distinguished from all other responsible actors in society — the politicians, legislators, educators, and scientists — by the fact that he is his own test tube, his own laboratory, working according to very rigorous rules, however unstated these may be, and cannot allow any consideration to supersede his responsibility to reveal all that he can possibly discover concerning the mystery of the human being.

Society must accept some things as real; but he must always know that visible reality hides a deeper one, and that all our action and achievement rest on things unseen. A society must assume that it is stable, but the artist must know, and he must let us know, that there is nothing stable under heaven. One cannot possibly build a school, teach a child, or drive a car without taking some things for granted.

The artist cannot and must not take anything for granted, but must drive to the heart of every answer and expose the question the answer hides”

 ~ James Baldwin*

Meet Graham

Over this past weekend I met Graham: the only person designed to survive on our roads. Graham is a remarkable sculpture. He has been designed with the bodily features that humans would need if we were to withstand motor vehicle crashes:

As much as we like to think we’re invincible, we’re not. But what if we were to change? What if our bodies were built to survive a low impact crash? What might we look like? The result of these questions is Graham, a reminder of just how vulnerable our bodies really are.

The piece forms part of the Towards Zero campaign – a vision for a future free of deaths and serious injuries on Australian roads:

In a shift from its traditional road safety campaigns, the Transport Accident Commission has collaborated with a leading trauma surgeon, a crash investigation expert and a world-renowned Melbourne artist to produce ‘Graham’, an interactive lifelike sculpture demonstrating human vulnerability.

Meeting Graham over the weekend was a revelation. As an injury prevention researcher, it is always exciting to be able to view and interact with innovative campaigns that take knowledge translation to the next level. This installation makes use of Google Tango, an immersive augmented reality technology, to allow the viewer to learn more about Graham’s unique features (such as his ribcage – my favourite feature – think airbags rather than armour). The campaign also features a school curriculum, and the ability to Meet Graham online – where one can view the sculpture in 360 degrees, as well as see videos from the surgeon, researcher, and artist.

Almost Impossible Cancer Spaghetti

In an innovative move, The BMJ is working with interactive data visualisation designerWill Stahl-Timmins, to present medical research findings in more visually appealing ways. His infographic development process, as detailed in the blog post Almost Impossible Cancer Spaghetti, is a fascinating study in attention to detail – something that communication and information designers are skilled at.

front

The knowledge translation gap

We know that a 17 year gap exists between research and its translation. The field of injury prevention – as an area of public health research – has a long and successful history with educational, media, and social marketing campaigns aimed at reducing this gap. In the quest for more rapid distribution of knowledge, many journals have moved toward open access publishing. Researchers are increasingly working to present research findings in more useful formats, including developing consensus statements, guidelines, and posters, as well as in more engaging formats such as apps, or – in the latest craze – designing their own infographics.

A pertinent question must be raised here: when does the pursuit of knowledge translation through formatting information in new and colourful ways tip over into the realm of creating “too much information” – merely adding to the sea of white noise rather than effectively increasing knowing and influencing behaviour change? We know that viral does not necessarily equal effective, and the problem remains that even if people do know about scientific evidence, they fail to use it anyway.

The intersection between injury prevention and the arts

In the age of viral marketing, art – to my mind – has a different quality, with new and exciting possibilities for better injury prevention knowledge and knowledge translation. Art provides the visual language for the kind of aesthetic knowing that is currently lacking in the ways in which we approach research and knowledge translation in this field. The arts are situated in the liminal space which moves us towards a different kind of embodied knowledge. Perhaps it is because art speaks to the unseen, in the words of James Baldwin.

Is there space in our field for fine art, design, sculpture, craft, poetry, spoken word, performance art, dance, music, photography, film-making? Should there be? What can we learn from other fields of research that do make use of arts-based methods? What can we learn from art itself?

This is not to say that researchers should necessarily be creating art and designing visual information themselves. We need to leave art to the artists, and design to the designers**. But perhaps we do need to collaborate with, and commission, artists and designers (and pay them!) to convey our messages in new and exciting ways – as the above two examples show. Further, the possibilities of arts-based research methods hold possibilities for the generation of different kinds of knowledge in our field, thereby enriching our understanding of injury and its prevention. A recent webinar from artist and academic Dr Mandy Archibald – on the intersection between the arts, research and knowledge translation – sheds light on this practice.

The examples of Meet Graham and the Almost Impossible Cancer Spaghetti have left me wholly inspired as to the possibilities of the art and science of injury prevention research and knowledge translation.

The science of injury prevention is ripe for collaboration with the arts.

I am curious as to other similar initiatives that sit at the intersection of injury prevention and art – please do share links in the comments section below.

*Of course, this was written at a time before the recognition of the importance of gender-neutral language

**Of course, all humans are creative and should all be making art – this statement refers solely to using art for knowledge translation purposes as part of specific research/advocacy projects

 

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

23 Oct, 16 | by Sheree Bekker

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[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

Quantifying the burden of injury in ‘data-poor’ setting; a local-need- driven approach?

12 Oct, 16 | by Brian Johnston

Editor’s Note: earlier this year the journal published injury data from the Global Burden of Disease project. In an accompanying editorial I noted that many of the regional or sub-national estimates were “derived from aggregation and extrapolation of limited primary sources “and yet could “become the basis for policy or programming at an intensely local level.”

I saw this as a challenge to researchers, a call to “crowd source” burden of disease data from  the subregions and subpopulations unrepresented, or simply estimated, in the global aggregate. If we identified those needs and provided resources for good data collection, data management and data reporting , the information collected would be immediately useful at the global scale and  – one hopes – at the local level too. 

Dr. Safa Abdalla, a member of our editorial board, approaches that suggestion with some caution and – in this guest post – draws distinctions between the needs and experience of researchers and public health professionals in “data-rich” and “data poor” environments. – Brian Johnston (Editor-in-Chief)

 

safa-abdallaSome parts of the world, typically in the low- and middle- income country classification range, lack solid basic information about frequency and distribution of injuries in their population. That is not to say that they lack the sources or the capacity to measure them, but in those same places, the public health practice machinery had been occupied (not entirely unduly of course) with a cluster of conditions like communicable diseases that international actors have been investing heavily to tackle. In such environment, local objective assessments of all potentially impactful conditions may not have been deemed necessary. As a result, priority setting has been skewed towards those conditions of historical focus without heavy reliance on local epidemiological evidence.
The very first global burden of disease and injury assessment and subsequent versions have highlighted the need to consider the burden of all realistically possible conditions that affect human health – including injuries – in a way that allows objective comparisons and consequently objective priority setting. Arguably, data from so called ‘data-poor’ countries had not always been sufficient and/or accessible enough to feed into these global-level estimation projects and data gaps were filled with an assortment of methods that continue to evolve to date, probably at a rate that surpasses the rate of improvement in the quantity and quality of data from those countries.
The burden of disease assessment methodology is very demanding, not only computationally but in terms of data input, requiring epidemiological estimates at the very granular level of disease and injury sequelae, and synthesizing those into a range of novel summary measures (Disability-adjusted life years for example). Yet, incidence, prevalence and mortality of any condition at a broader level are key inputs for country- or locality-level policy development and health service planning and monitoring. It is in measuring those epidemiological quantities that the value of country-level estimation in data-poor settings lies, without necessarily delving into the complexities (and relatively unnecessary luxury for the time-being) of summary measure calculation. In addition, country-level assessments can uncover gaps in data systems that, when addressed, can create a seamless flow of better quality data for local decision making.
But with whom does the onus of carrying out such local-level estimation reside? Undeniably, global estimation efforts have produced country-specific estimates, stimulated country data hunts that fed data into their machinery and, in a few ‘data-rich’ countries, facilitated full burden of disease and injury assessments too. However, to date, injury burden estimates for the vast majority of ‘data-poor’ countries come from indirect estimation in these global projects. One can argue that alternatively, an approach that is driven by the need for public health action (be it strategy updating or service development) would be the most beneficial for producing estimates for those very countries at national, sub-national or subgroup levels. This approach entails that a local team of researchers, public health practitioners and other stakeholders evaluate all their data sources, use them in a simple and transparent fashion to develop the best estimates that fit their purpose, and take action based on the estimates and other relevant input while also identifying the data gaps and working on filling them. Arguably, informing local public health action should take priority over informing the global view, but global burden estimation efforts can still (and must) benefit from the products of this process. However, the process needs to be driven by local demand for estimates and not by the need to fill gaps for the global estimates. It should also be led, undertaken and owned by local teams of public health practitioners, analysts and researchers. The reason for this is that assessing and using health data are basic public health functions that all public health practitioners and analysts in any country should be capable of carrying out. Relying on external support from ‘global project’ teams to develop country estimates denies public health practitioners and researchers in those ‘data-poor’ countries the opportunity to hone their skills in public health data assessments and epidemiological estimation. It also denies them ownership of any subsequent efforts to improve data availability via epidemiological studies or administrative data collection.
This approach need not be limited to injury burden assessment but is much more needed for that latter. This is mainly because injuries in many low- and middle- income countries had been neglected for so long that epidemiological assessments of other conditions traditionally associated with those countries are likely more abundant. Hopefully as more and more country teams assess, use and improve their own injury data sources, this reality will eventually change.

Safa Abdalla
drsafa@yahoo.com
twitter: @Safa12233

Guest Blog: ‘Breaking Down Walls – Taking Translation and Dissemination to the Next Level’

26 Sep, 16 | by Angy El-Khatib

 

Often, when people think of translational research, it is through the lens of Grand Rounds, seminars, and conference presentations. It is usually clinical in nature and comes directly from the researcher. There is another type of translational research – NIH calls it Type 2 translation.

I am part of a Type 2 translational research team at a child injury research center. Our team of five has a mission to educate and empower the vast audience of people who care about kids and keeping them safe. We do this by sharing information on child injury in a format that is accessible by meeting health literacy guidelines and providing opportunities for prevention through realistic, actionable safety steps.

That’s a pretty lofty goal but we are very good at what we do. When researchers from our center publish papers, it is not unusual for their work to be picked up by media around the world. In the last six months, we’ve had two papers that had over one billion impressions (estimates of potential audience size), and two others that have had around one million impressions. It helps that our product is related to kids – it makes people care. But there is more to it than that.

In working with media, we strive to understand their needs and how to create value for them to cover our work. This is not as simple as it sounds. We spend several days working on a press release. Our hospital sees the value in the work we do and often contributes resources for us to create supporting videos, including sound bites, demonstrations, and B-roll.

We pay attention to the ever-changing way the masses consume information, staying up to date on the pulse of the public to meet them where they are. Gone are the early days of technology where you could create a website, direct people there, and then forget about it. Now, a website must stay fresh, providing new content frequently. It must also stay current in the way it looks. If its appearance is outdated, no one will look at your information because there will be the assumption (correct or not) that what is on the site is also likely outdated. People may believe you and/or your organization are outdated, or worse yet, irrelevant. We constantly assess social media platforms, analyze how we can best use them for maximum effect, and then develop our marketing plans.

We talk to doctors, administrators, researchers, and other public health professionals about the findings of our research. We also train them to effectively communicate with those who trust them and look to them for guidance. After that, we can’t sit back and rest on our laurels – we have to do it all over again, and then again. By doing all of this, we increase the likelihood of and the speed with which our research can lead to changes in policy, regulation, and behavior.

In the realm of translational research, teams like ours are not the norm and our team didn’t become this successful overnight. When our manager began her quest to have a team devoted to translational research, translation and dissemination were barely on the radar. Beyond journal publication, dissemination typically just meant printing  copies of a paper and having it available upon request or presenting it at conferences. Our manager had a vision of something bigger and better. She specializes in health communication and has the passion and drive to push for what she believes in. Her director supported her vision and was willing to take a chance on, and fund, something that really hadn’t been done.

Slowly, she grew her team. What makes us effective and successful is that although we each have our own projects to manage, we bring our complementary sets of skills and experiences to the table, both literally and figuratively, collaborating on all of our products. These products include press releases, multi-media releases, media interviews, blog articlescynthia-anderson-profile-picture, website development and management, social media outreach, toolkits, photo shoots, conference planning, and network building. We hone our work through brainstorming sessions, writes, edits, and re-writes. Our work is always better after it has been through the rounds of the team.

Our manager began winning over colleagues one researcher at a time, as they saw the reach and the impact of their work grow. It took 10 years for her to get her team to where we are now – having a big impact and doing innovative work that can help keep kids safer.

Written by:
Cynthia Anderson, MPH, CHES.
She is a Program Coordinator at The Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio. She can be contacted at cynthia.anderson@nationwidechildrens.org.

 

 

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.

How to cut violence painlessly: Increase alcohol taxes

1 Sep, 16 | by Sheree Bekker

photo-1455641064490-74f5f8dbf598

[SB] This post is by Nicholas Page and Jonathan Shepherd.

Nicholas Page is a Senior Research Assistant at the Wales Institute of Social and Economic Research, Data and Methods (WISERD) and former Research Associate at Cardiff University’s Violence Research Group. Follow Nick on Twitter @Nick_Alan_Page

Jonathan Shepherd is a Professor of Oral and Maxillofacial Surgery and Director of the award winning Violence Research Group based at Cardiff University. Follow the Violence Society RG on Twitter @ViolenceSociety

[NP & JS] Alcohol abuse is a major risk factor for violence. For this reason, interventions seeking to reduce alcohol consumption often form a central part of violence prevention strategies, both globally and domestically. Increasing the price of alcohol, for instance, has been linked to significant reductions in many alcohol-related disease and injury conditions, including violent injury. A study in England and Wales, for example, found a negative relationship between violent injury and the price of beer, after accounting for other potentially influential factors. The logic here is that higher prices mean we buy and drink less alcohol – an assumption that is well supported by numerous peer-reviewed studies. From this, we understand the relationship between alcohol price and violence as a two-stage process; first, from alcohol price to alcohol consumption and second, from alcohol consumption to acts of violence.

But, in this previous study, violence was measured using rates of emergency department (ED) attendance between 1995 and 2000, and the price of beer was based on the average value of a single pub-bought (tavern-bought) pint over the same period. Acknowledging that purchasing trends and licensing laws have changed over the last two decades, we at Cardiff University’s Violence Research Group – the authors of the original study – repeated the study using the same ED violence measure but substantially extended the scope of the research beyond the price just of beer and on-license prices.

This latest study – recently published online in Injury Prevention – compares violence-related attendances from 100 EDs across England and Wales between 2005 and 2012, with alcohol prices (including beers, wines, spirits, and ‘alcopops’ – flavoured alcoholic beverages) from both on-trade (e.g. pubs and clubs) and off-trade (e.g. supermarkets and off-licenses) alcohol outlets. In support of our previous finding, the risk of violent injury was once more strongly negatively related to the price of alcohol in both outlet types; again, taking into account the influence of other potential confounding factors.

The implications of these findings are both theoretical and practical. First, because alcohol prices are not affected by rates of violence, the argument that links between violence and alcohol simply reflect the propensity of violent people to drink more alcohol than people who are nonviolent can be dismissed in this instance. Second, and most importantly, our findings showed that as little as a 1% increase in alcohol prices could reduce the number of patients attending EDs for treatment of violence-related injuries in England and Wales by around 6,000 patients per year. Crucially, to achieve such a substantial reduction, the price of alcohol must be raised in both on-trade and off-trade outlets. This would mean, since on-trade prices were found to be more influential in driving violence and that alcohol prices in this trade are already far in excess of the proposed minimum unit price (MUP) range of around 45-50 pence in the UK, that alcohol pricing policies which focus on tax increases are likely to have a greater influence on violent injury than MUP.

Together with similar findings from the USA, this research provides compelling evidence that making alcohol more expensive would reduce violence. Increasing the price of alcohol through tax increases is a national intervention which would be relatively straightforward to implement. The evidence speak for itself: even small price increases could substantially reduce alcohol-related harms, lead to safer towns and cities, decrease costs to health and criminal justice services, and increase revenue for governments.

So what are policy makers waiting for?

 

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