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Data linkage: overcoming a potential injury prevention obstacle

23 Jun, 14 | by Bridie Scott-Parker

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

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

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

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

Injury prevention and the musician

16 Jun, 14 | by Bridie Scott-Parker

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

Miss Imogen Scott-Parker preparing for a concert

Miss Imogen Scott-Parker preparing for a concert

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

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

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

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

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

2 Jun, 14 | by Bridie Scott-Parker

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

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

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

The Fatality Free Friday website states:

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

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

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

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

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

How can you be active in injury prevention?

 

Look for injury prevention ideas everywhere

26 May, 14 | by Bridie Scott-Parker

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

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

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

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

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

 

Harborview Injury Prevention Research Centre has new director

15 May, 14 | by Barry Pless

monika1

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

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

From evidence to policy and practice

13 May, 14 | by Bridie Scott-Parker

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

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

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

* the Minister and the government,

* lawyers, and

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

I love the idea of working smarter, not harder!

Motorcycle crashes decline: thank the weather

7 May, 14 | by Barry Pless

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

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

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

Wealth begets longevity (more so for some than others!)

29 Apr, 14 | by Barry Pless

An article in the Wall Street Journal, featured recently in Mother Jones, reminds us that the richer you are, the longer you’ll live. And that the gap is widening, particularly among women. The article notes that a man born in 1940 would be mid-career in 1980 and if his income was in the top 10% for his age group and he lived to age 55 he can expect to live an additional 34.9 years. This is six years longer than a man whose career followed the same arc, but who was born in 1920. (I squeezed in between those dates so I will split the difference). The important message is that for women ‘at every income level, for both those born in 1920 and 1940, women live longer than men. But for women, the longevity and income trends are even more striking. While the wealthiest women from the 1940s are living longer, the poorest 40% are seeing life expectancy decline from the previous generation.’ In other words, “At the bottom of the distribution, life is not improving rapidly for women anymore.” Part of the explanation may be differences in smoking rates but somewhat disappointing (but not surprising) is the failure to examine the well-known differences by income and by sex for fatal injuries. A mid-career paper that I co-authored addressed part of this topic for motor vehicle injuries and deaths in children. (Social class and the occurrence of traffic injuries and deaths in urban children. G Dougherty, IB Pless, R Wilkins – Canadian Journal of Public Health. 1989).   I have been interested in this topic ever since and still am uncertain whether the difference is driven (no pun intended) by environmental features associated with low income, worse driving, poorer enforcement, all of the above, or many other factors. I wonder what readers of this blog think.

Although the WSJ article raised questions about the implications of these findings for Social Security equity in the U.S., for me they served as a reminder that we still do not have good explanations for the large and persistent sex and social class differences in injury mortality.

http://blogs.wsj.com/economics/2014/04/18/the-richer-you-are-the-older-youll-get/

Poorly-fitted child seats an injury waiting to happen

24 Apr, 14 | by Bridie Scott-Parker

Thinking about the recalls yesterday, particularly those related to child seats, reminded me of a recent story I read recently. A 2013 survey of over 10,000 child seats in England, Wales and Scotland revealed that 60% of the child seats were poorly-fitted (see http://www.express.co.uk/news/uk/470156/Millions-of-infants-at-risk-60-per-cent-of-all-child-seats-not-fitted-safely). One poorly-fitted child seat is a problem, let alone 6,000 in a sample of 10,000. This statistic is alarming.

Why is this an issue? According to Kevin Clinton, head of Road Safety at the Royal Society for Prevention of Accidents in the United Kingdom,

“The importance of properly fitting a child seat cannot be overstated. Make sure it is compatible with the car and remember to seek expert help on fitting. We encourage parents to check that the seat is fitted correctly before every journey, esp­ecially if they are regularly taking it in and out of the car.”

He urged the public to “avoid purchasing second-hand car seats as they might not comply with the latest standards, the fitting instructions may be missing and you cannot be sure of their history, such as whether they have been in an accident.”

So why isn’t the message getting through to parents? As a parent myself, I cannot imagine another parent willingly installing a child seat in an unsafe manner, deliberately putting their child in harm’s way. How do stakeholders important in injury prevention get the message across?

Timely action is particularly important when we consider that our most vulnerable could be travelling at 110km/hr, with parents mistakenly believing that their child is as safe as possible. Timely action is also especially important when we realise that this has been an issue for some time (eg., a 2011 story reporting similar statistics: http://www.theguardian.com/money/2011/sep/17/child-car-seats-motoring).

It will continue to be an issue unless more is done, and sooner rather than later.

 

Recalls on the radar

23 Apr, 14 | by Bridie Scott-Parker

Over the past few months I have noticed an abundance of recalls for various products, including mass recalls after ignition switch defects in General Motors cars. As noted on their website (http://www.gmignitionupdate.com/faq.html),

“There is a risk, under certain conditions, that your ignition switch may move out of the “run” position, resulting in a partial loss of electrical power and turning off the engine. This risk increases if your key ring is carrying added weight (such as more keys or the key fob) or your vehicle experiences rough road conditions or other jarring or impact related events. If the ignition switch is not in the run position, the air bags may not deploy if the vehicle is involved in a crash, increasing the risk of injury or fatality.

Additionally, some of these vehicles have a condition in which the ignition key may be removed when the vehicle gear is not in the “Off” position. If the ignition key is removed when the ignition is not in the “Off” position, unintended vehicle motion may occur: (a) for an automatic transmission, if the transmission is not in “Park”; or (b) for a manual transmission, if the parking brake is not engaged and the transmission is not in reverse gear. This could result in a vehicle crash and occupant or pedestrian injuries.”

Alarmingly many of these recent recalls are products intended to protect our youngest and most vulnerable, for example child seats (eg., faulty harness buckles, http://www.usatoday.com/story/money/business/2014/03/13/graco-adds-more-child-seats-to-recall/6365789/), and cots (eg., possible entrapment of infant limbs,  http://www.recalls.gov.au/content/index.phtml/itemId/1054130).

Some food-related recalls are of particular concern, given the potentially-life threatening nature of many nut allergies (eg., cereal, http://www.recalls.gov.au/content/index.phtml/itemId/1057890; Easter eggs, http://www.recalls.gov.au/content/index.phtml/itemId/1057600).

Whilst I have heard about these recalls through different means (such as newspapers, online forums, and active research for this blog), I wonder how many of the products’ consumers actually know about these recalls? We received a letter earlier this year advising that our model of Sonata required a minor tweak to circumvent potential brake-related issues (ironically enough this ‘minor tweak’ radically affected the vehicle’s braking, as the replacement part itself was faulty). What if the consumer has moved address (which is entirely possible given we purchased the vehicle 5 years ago), does not have internet access, and does not subscribe to or read a newspaper? Should there be greater onus on producers to not only ensure that they have as safe a product as possible in the marketplace, but that they also make every effort (and not a ‘token’ effort) to ensure that they minimise any potential harm that could be caused by their faulty product by ensuring they recall, then repair/replace these products, in a timely manner for the consumer?

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