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Open AccessArticle Nrf2-Knockout Protects from Intestinal Injuries in C57BL/6J Mice Following Abdominal Irradiation with γ Rays

by Wenyan Yang, Zhijuan Sun, Bing Yang and Qin Wang

Int. J. Mol. Sci. 2017, 18(8), 1656; doi:10.3390/ijms18081656

Received: 7 July 2017 / Revised: 23 July 2017 / Accepted: 27 July 2017 / Published: 31 July 2017

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Abstract

Radiation-induced intestinal injuries (RIII) commonly occur in patients who suffer from pelvic or abdominal cancer. Nuclear factor-erythroid 2-related factor 2 (Nrf2) is a key transcriptional regulator of antioxidant, and the radioprotective role of Nrf2 is found in bone marrow, lung, and intestine, etc.

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Radiation-induced intestinal injuries (RIII) commonly occur in patients who suffer from pelvic or abdominal cancer. Nuclear factor-erythroid 2-related factor 2 (Nrf2) is a key transcriptional regulator of antioxidant, and the radioprotective role of Nrf2 is found in bone marrow, lung, and intestine, etc. Here, we investigated the effect of Nrf2 knockout on radiation-induced intestinal injuries using Nrf2 knockout (Nrf2^−/−) mice and wild-type (Nrf2^+/+) C57BL/6J mice following 13 Gy abdominal irradiation (ABI). It was found that Nrf2 knockout promoted the survival of irradiated mice, protected the crypt-villus structure of the small intestine, and elevated peripheral blood lymphocyte count and thymus coefficients. The DNA damage of peripheral blood lymphocytes and the apoptosis of intestinal epithelial cells (IECs) of irradiated Nrf2^−/− mice were decreased. Furthermore, compared with that of Nrf2^+/+ mice, Nrf2 knockout increased the number of Lgr5⁺ intestinal stem cells (ISCs) and their daughter cells including Ki67⁺ transient amplifying cells, Villin⁺ enterocytes, and lysozyme⁺ Paneth cells. Nuclear factor-κB (NF-κB) was accumulated in the crypt base nuclei of the small intestine, and the mRNA expression of NF-κB target genes Bcl-2, uPA, and Xiap of the small intestine from irradiated Nrf2^−/− mice were increased. Collectively, Nrf2 knockout has the protective effect on small intestine damage following abdominal irradiation by prompting the proliferation and differentiation of Lgr5⁺ intestinal stem cells and activation of NF-κB. Full article

(This article belongs to the Special Issue Nrf2 in Redox Signaling: A Double Edged Sword)

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Open AccessArticle Trend Analysis of Construction Industrial Accidents in Korea from 2011 to 2015

by Byung Wan Jo, Yun Sung Lee, Jung Hoon Kim and Rana Muhammad Asad Khan

Sustainability 2017, 9(8), 1297; doi:10.3390/su9081297

Received: 29 May 2017 / Revised: 19 July 2017 / Accepted: 22 July 2017 / Published: 25 July 2017

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Abstract

The purpose of this study is to analyze the results of construction accidents occurred from 2011 to 2015 in Korea. The annual reports from the Ministry of Employment and Labor, Korea (MOEL), and the annual reports from the Statistics Korea were used for

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The purpose of this study is to analyze the results of construction accidents occurred from 2011 to 2015 in Korea. The annual reports from the Ministry of Employment and Labor, Korea (MOEL), and the annual reports from the Statistics Korea were used for the analysis in this study. The gender, age, company size and accident types were chosen as a category to analyze the trend of various occupational accidents. In order to analyze the characteristics of construction accidents, incidence rates (IRs) and mortality rates (MRs) were calculated. Further, T-tests and ANOVA analysis were performed to discover the relationships among IRs, MRs, and chosen categories. Male workers’ IRs and MRs were significantly higher than those of female workers. Construction workers over 40 years of age suffered the most from occupational injuries. In terms of company size, as company size increases, both IRs and MRs tended to decrease. Occupational injuries caused by falls were higher than other accident types each year. This paper will be able to provide information on occupational accidents for establishing strategies to reduce the accident rate in construction sectors of Korea. Full article

(This article belongs to the Special Issue Risk Assessment and Management)

Open AccessArticle Impact of First Aid on Treatment Outcomes for Non-Fatal Injuries in Rural Bangladesh: Findings from an Injury and Demographic Census

by Dewan Md Emdadul Hoque, Md Irteja Islam, Shumona Sharmin Salam, Qazi Sadeq-ur Rahman, Priyanka Agrawal, Aminur Rahman, Fazlur Rahman, Shams El-Arifeen, Adnan A. Hyder and Olakunle Alonge

Int. J. Environ. Res. Public Health 2017, 14(7), 762; doi:10.3390/ijerph14070762

Received: 24 May 2017 / Revised: 3 July 2017 / Accepted: 9 July 2017 / Published: 12 July 2017

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Abstract

Non-fatal injuries have a significant impact on disability, productivity, and economic cost, and first-aid can play an important role in improving non-fatal injury outcomes. Data collected from a census conducted as part of a drowning prevention project in Bangladesh was used to quantify

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Non-fatal injuries have a significant impact on disability, productivity, and economic cost, and first-aid can play an important role in improving non-fatal injury outcomes. Data collected from a census conducted as part of a drowning prevention project in Bangladesh was used to quantify the impact of first-aid provided by trained and untrained providers on non-fatal injuries. The census covered approximately 1.2 million people from 7 sub-districts of Bangladesh. Around 10% individuals reported an injury event in the six-month recall period. The most common injuries were falls (39%) and cuts injuries (23.4%). Overall, 81.7% of those with non-fatal injuries received first aid from a provider of whom 79.9% were non-medically trained. Individuals who received first-aid from a medically trained provider had more severe injuries and were 1.28 times more likely to show improvement or recover compared to those who received first-aid from an untrained provider. In Bangladesh, first-aid for non-fatal injuries are primarily provided by untrained providers. Given the large number of untrained providers and the known benefits of first aid to overcome morbidities associated with non-fatal injuries, public health interventions should be designed and implemented to train and improve skills of untrained providers. Full article

(This article belongs to the collection A Million Person Household Survey: Understanding the Burden of Injuries in Bangladesh)

Open AccessArticle An Intervention to Reduce Bicycle Injuries among Middle School Students in Rural China

by Yanhu Ji, Yanru Ye, Yaogui Lu, Liping Li and Yang Gao

Int. J. Environ. Res. Public Health 2017, 14(7), 690; doi:10.3390/ijerph14070690

Received: 5 May 2017 / Revised: 16 June 2017 / Accepted: 16 June 2017 / Published: 26 June 2017

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Abstract

This study aimed to evaluate the effectiveness of an intervention to reduce bicycle injuries among rural middle school students in China. A one-year cluster-randomized controlled trial was conducted with seventh grade students from six middle schools in two towns in rural Chaoshan, China.

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This study aimed to evaluate the effectiveness of an intervention to reduce bicycle injuries among rural middle school students in China. A one-year cluster-randomized controlled trial was conducted with seventh grade students from six middle schools in two towns in rural Chaoshan, China. The two towns were randomly assigned to either the intervention or control group. Road safety education materials, two lectures on road safety, and a series of health education activities were delivered to 1312 students in the intervention group over one year, and the content of the intervention included traffic safety knowledge, methods of preventing bicycle injury and management of bicycle injuries. Questionnaires weere administered to the two groups before and after the intervention to measure the incidence, cognitions, and behaviors related to bicycle injuries. The pre-intervention incidence of bicycle injuries exhibited no significant difference between the two groups, while the difference reached significance after the intervention (χ² = 13.409, p < 0.001). In the intervention group, the incidence decreased significantly after the intervention (χ² = 8.137, p = 0.004), while no significant change was observed in the control group. Publicity and education intervention measures have certain short-term effects on the prevention of bicycle injuries among rural middle school students; we should approach intervention measures according to the characteristics of traffic injuries in different areas. Full article

(This article belongs to the Section Global Health)

Open AccessArticle Prevalence of Injuries during Brazilian Jiu-Jitsu Training

by Alex R. McDonald, Fred A. Murdock, Jr., Josh A. McDonald and Christopher J. Wolf

Sports 2017, 5(2), 39; doi:10.3390/sports5020039

Received: 17 April 2017 / Revised: 5 June 2017 / Accepted: 8 June 2017 / Published: 12 June 2017

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Abstract

Brazilian jiu-jitsu (BJJ) is a martial art that focuses on groundwork, joint locks, and chokeholds. The purpose of this study is to determine the prevalence of injuries sustained during BJJ training. A 27-question research survey was e-mailed to 166 BJJ gyms in the

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Brazilian jiu-jitsu (BJJ) is a martial art that focuses on groundwork, joint locks, and chokeholds. The purpose of this study is to determine the prevalence of injuries sustained during BJJ training. A 27-question research survey was e-mailed to 166 BJJ gyms in the United States. Demographic information, belt level, weight class, training hours, competition experience, and injury prevalence data were collected. The majority of respondents were Caucasian (n = 96) males (n = 121) with an average age of 30.3 years. Overall, the most common injury locations were to the hand and fingers (n = 70), foot and toes (n = 52), and arm and elbow (n = 51). The most common medically diagnosed conditions were skin infections (n = 38), injuries to the knee (n =26), and foot and toes (n = 19). The most common non-medically diagnosed injuries occurred to the hand and fingers (n = 56), arm and elbow (n = 40), and foot and toes (n = 33). In general, athletes were more likely to sustain distal rather than proximal injuries. Athletes reported more frequent medically diagnosed injuries to the lower extremity and more frequent self-diagnosed injuries to the upper extremity. Upper extremity injuries appear to be more frequent but less severe than lower extremity injuries with the opposite being true for lower extremity injuries. Full article

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Open AccessArticle Work-Related Eye Injuries: A Relevant Health Problem. Main Epidemiological Data from a Highly-Industrialized Area of Northern Italy

by Fabriziomaria Gobba, Enrico Dall’Olio, Alberto Modenese, Michele De Maria, Luca Campi and Gian Maria Cavallini

Int. J. Environ. Res. Public Health 2017, 14(6), 604; doi:10.3390/ijerph14060604

Received: 9 March 2017 / Revised: 29 May 2017 / Accepted: 31 May 2017 / Published: 6 June 2017

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Abstract

The province of Modena is one of the most industrialized areas of Northern Italy. The medical records of the Ophthalmological Emergency Department (OED) of Modena University Hospital were studied: there were 13,470 OED accesses in 2014 and in 754 cases that an occupational

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The province of Modena is one of the most industrialized areas of Northern Italy. The medical records of the Ophthalmological Emergency Department (OED) of Modena University Hospital were studied: there were 13,470 OED accesses in 2014 and in 754 cases that an occupational eye injury occurred. The frequency of work-related eye injuries (3‰) was lower compared to other published studies, but the absolute number is still relevant, showing the need for more adequate prevention, especially in metal work, construction work, and agriculture, where the worst prognoses were observed. Intervention programs must be implemented as early as possible in the working life, considering that the frequency in younger workers is about double that of the oldest age class (3.5‰ vs. 1.8‰), and special attention should also be given to foreigners, who have a 50% higher injury risk. Furthermore, the planning of specific interventions for eye-injured workers may be useful, considering that a previous injury does not appear to encourage the adoption of preventive interventions, and a subgroup of eye-injured workers have a potential risk for new injuries. Finally, the data presented here indicates how OED records, integrated with specific occupational information, can be applied for studies on work-related eye injuries. Full article

(This article belongs to the Section Global Health)

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Open AccessArticle Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injuries in Victoria, Australia 2005–2015

by Louise Shaw and Caroline F. Finch

Int. J. Environ. Res. Public Health 2017, 14(6), 599; doi:10.3390/ijerph14060599

Received: 26 April 2017 / Revised: 29 May 2017 / Accepted: 31 May 2017 / Published: 5 June 2017

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Abstract

Anterior cruciate ligament (ACL) injuries in children and adolescents have been the focus of recent media attention and parental concern, given their potential for adverse long-term health outcomes and healthcare costs. However, there is limited formal evidence on trends in the incidence of

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Anterior cruciate ligament (ACL) injuries in children and adolescents have been the focus of recent media attention and parental concern, given their potential for adverse long-term health outcomes and healthcare costs. However, there is limited formal evidence on trends in the incidence of ACL injuries in children. This study utilizes the Victorian Admitted Episodes Dataset (VAED) to characterize epidemiologic trends of hospital-admitted ACL injuries in those aged 5 to 14 years over a period of 10 years from 2005 to 2015. There was a total of 320 cases and the overall annual rate of ACL injuries increased by 147.8% from 2.74 per 100,000 population in 2005/2006 to 6.79 per 100,000 in 2014/2015. The majority (96.9%) of these injuries were in 10- to 14-year-olds. The main in-hospital procedure provided to over 80% of the hospitalized cases involved ACL reconstruction. Sporting activities accounted for 56.6% of ACL injuries. For females, over half (52.4%) of ACL injuries occurred whilst playing ball sports, compared to 35.4% of males. The large increase in ACL injuries in 5- to 14-year-olds in the state of Victoria, Australia over a 10-year period indicates they are a significant and emerging health burden. Population-wide ACL prevention policies are required to halt these trends. Cost effective prevention programs that involve neuromuscular training must be implemented in schools and junior sports teams. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

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Open AccessReview Interventions Aimed at the Prevention of Childhood Injuries in the Indigenous Populations in Canada, Australia and New Zealand in the Last 20 Years: A Systematic Review

by Alyssa Margeson and Selena Gray

Int. J. Environ. Res. Public Health 2017, 14(6), 589; doi:10.3390/ijerph14060589

Received: 16 April 2017 / Revised: 24 May 2017 / Accepted: 27 May 2017 / Published: 2 June 2017

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Abstract

Globally, Indigenous children are found to be at a significantly higher risk of injury compared to non-Indigenous children. It has been suggested that mainstream injury prevention strategies are ineffective within Indigenous communities. The aim of this review is to identify existing interventions aimed

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Globally, Indigenous children are found to be at a significantly higher risk of injury compared to non-Indigenous children. It has been suggested that mainstream injury prevention strategies are ineffective within Indigenous communities. The aim of this review is to identify existing interventions aimed at preventing injury in Indigenous children in the hope that it guides future strategies. To the best of the authors’ knowledge, no prior systematic reviews exist looking at interventions specifically aimed at preventing injury in Indigenous child populations in the three chosen countries. Electronic databases were systematically searched for relevant childhood interventions aimed at the prevention of injuries in Indigenous populations based in Canada, Australia and New Zealand from 1996 to 2016. A manual search of the reference lists of relevant articles and a manual search of relevant websites were also completed. After 191 records were screened, six interventions were identified meeting the criteria for inclusion. Eligible papers underwent a quality appraisal using adapted assessment checklists and key information was extracted. Findings were then synthesized using a narrative approach. The interventions mainly promoted child safety through activities focusing on education and awareness. Only three of the six studies measured changes in injury hospitalization rates, all but one evaluation reporting a significant decrease. Studies which measured awareness all demonstrated positive changes. Results suggest that interventions delivered in a culturally appropriate manner acted as a main success factor. Barriers identified as hindering intervention success included lack of cohesion within the intervention due to staff turnover and lack of experienced staff with Indigenous knowledge. This review revealed a limited amount of evaluated interventions for the prevention of Indigenous childhood injuries. Conclusive evidence of the effectiveness of existing interventions is lacking due to the predominantly small-scale evaluations of pilot interventions. Future research is needed to provide more rigorous evidence of the mechanisms driving the successful implementation, delivery and uptake of such strategies tailored to Indigenous children. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

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Open AccessArticle Caregiver Supervision Practices and Risk of Childhood Unintentional Injury Mortality in Bangladesh

by Khaula Khatlani, Olakunle Alonge, Aminur Rahman, Dewan Md. Emdadul Hoque, Al-Amin Bhuiyan, Priyanka Agrawal and Fazlur Rahman

Int. J. Environ. Res. Public Health 2017, 14(5), 515; doi:10.3390/ijerph14050515

Received: 15 February 2017 / Revised: 3 May 2017 / Accepted: 5 May 2017 / Published: 11 May 2017

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Abstract

Unintentional injury-related mortality rate, including drowning among children under five, is disproportionately higher in low- and middle-income countries. The evidence links lapse of supervision with childhood unintentional injury deaths. We determined the relationship between caregiver supervision and unintentional injury mortality among children under

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Unintentional injury-related mortality rate, including drowning among children under five, is disproportionately higher in low- and middle-income countries. The evidence links lapse of supervision with childhood unintentional injury deaths. We determined the relationship between caregiver supervision and unintentional injury mortality among children under five in rural Bangladesh. We conducted a nested, matched, case-control study within the cohort of a large-scale drowning prevention project in Bangladesh, “SOLID—Saving of Children’s Lives from Drowning”. From the baseline survey of the project, 126 cases (children under five with unintentional injury deaths) and 378 controls (alive children under five) were selected at case-control ratio of 1:3 and individually matched on neighborhood. The association between adult caregiver supervision and fatal injuries among children under five was determined in a multivariable conditional logistic regression analysis, and reported as adjusted matched odds ratio (MOR) with 95% confidence intervals (CIs). Children under five experiencing death due to unintentional injuries, including drowning, had 3.3 times increased odds of being unsupervised as compared with alive children (MOR = 3.3, 95% CI: 1.6–7.0), while adjusting for children’s sex, age, socioeconomic index, and adult caregivers’ age, education, occupation, and marital status. These findings are concerning and call for concerted, multi-sectoral efforts to design community-level prevention strategies. Public awareness and promotion of appropriate adult supervision strategies are needed. Full article

(This article belongs to the collection A Million Person Household Survey: Understanding the Burden of Injuries in Bangladesh)

Open AccessArticle Injuries in Collegiate Women’s Volleyball: A Four-Year Retrospective Analysis

by Christopher J. Sole, Ashley A. Kavanaugh and Michael H. Stone

Sports 2017, 5(2), 26; doi:10.3390/sports5020026

Received: 31 January 2017 / Revised: 20 April 2017 / Accepted: 5 May 2017 / Published: 10 May 2017

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Abstract

A four-year retrospective analysis of injury data was conducted on a collegiate (NCAA Division I) women’s volleyball team. Twenty athletes (Year 1: age = 19.4 ± 0.9 y, height = 175.2 ± 5.1 cm, body mass = 70.5 ± 10.2 kg; Year 2:

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A four-year retrospective analysis of injury data was conducted on a collegiate (NCAA Division I) women’s volleyball team. Twenty athletes (Year 1: age = 19.4 ± 0.9 y, height = 175.2 ± 5.1 cm, body mass = 70.5 ± 10.2 kg; Year 2: age = 20.1 ± 1.0 y, height = 175.7 ± 4.7 cm, body mass = 69.5 ± 10.1 kg; Year 3: age = 20.1 ± 1.4 y, height = 173.8 ± 6.3 cm, body mass = 69.9 ± 10.8 kg; Year 4: age = 19.5 ± 1.4 y, height = 174.4 ± 8.6 cm, body mass = 72.7 ± 10.8 kg) participated in this study, accounting for 1483 total training exposures. Injury was defined as any damage to a body part, incurred during volleyball or strength and conditioning-related activities, which interfered with training and/or competition. Injury rate was normalized to the number of athletes and exposure and expressed as injuries per 1000 exposures. A total of 133 injuries were recorded. The most common injury was to the knee (left = 7.5%, right = 12.0%). Injuries occurred most often in volleyball practice (75.2%), followed by competition (20.3%), and strength and conditioning-related activities (4.5%). Non-contact injuries (upper body = 26.3%, lower body = 53.4%) were more common than contact injuries (upper-body = 13.5%, lower-body = 6.8%). An examination of injury rates relative to the training year revealed patterns in injury occurrence. Specifically, spikes in injury rate were consistently observed during periods of increased training volume that were preceded by breaks in organized training, such as the early pre-season and off-season training periods. Full article

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Open AccessArticle Care-Seeking Patterns and Direct Economic Burden of Injuries in Bangladesh

by Yira Natalia Alfonso, Olakunle Alonge, Dewan Md Emdadul Hoque, Md Kamran Ul Baset, Adnan A. Hyder and David Bishai

Int. J. Environ. Res. Public Health 2017, 14(5), 472; doi:10.3390/ijerph14050472

Received: 6 February 2017 / Revised: 7 April 2017 / Accepted: 21 April 2017 / Published: 29 April 2017

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Abstract

This study provides a comprehensive review of the care-seeking patterns and direct economic burden of injuries from the victims’ perspective in rural Bangladesh using a 2013 household survey covering 1.17 million people. Descriptive statistics and bivariate analyses were used to derive rates and

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This study provides a comprehensive review of the care-seeking patterns and direct economic burden of injuries from the victims’ perspective in rural Bangladesh using a 2013 household survey covering 1.17 million people. Descriptive statistics and bivariate analyses were used to derive rates and test the association between variables. An analytic model was used to estimate total injury out-of-pocket (OOP) payments and a multivariate probit regression model assessed the relationship between financial distress and injury type. Results show non-fatal injuries occur to 1 in 5 people in our sample per year. With average household size of 4.5 in Bangladesh--every household has an injury every year. Most non-fatally injured patients sought healthcare from drug sellers. Less than half of fatal injuries sought healthcare and half of those with care were hospitalized. Average OOP payments varied significantly (range: $8–$830) by injury type and outcome (fatal vs. non-fatal). Total injury OOP expenditure was $355,795 and $5000 for non-fatal and fatal injuries, respectively, per 100,000 people. The majority of household heads with injuries reported financial distress. This study can inform injury prevention advocates on disparities in healthcare usage, OOP costs and financial distress. Reallocation of resources to the most at risk populations can accelerate reduction of preventable injuries and prevent injury related catastrophic payments and impoverishment. Full article

(This article belongs to the collection A Million Person Household Survey: Understanding the Burden of Injuries in Bangladesh)

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Open AccessArticle Hyponatremia Is Associated with Worse Outcomes from Fall Injuries in the Elderly

by Spencer C. H. Kuo, Pao-Jen Kuo, Cheng-Shyuan Rau, Shao-Chun Wu, Shiun-Yuan Hsu and Ching-Hua Hsieh

Int. J. Environ. Res. Public Health 2017, 14(5), 460; doi:10.3390/ijerph14050460

Received: 13 March 2017 / Revised: 17 April 2017 / Accepted: 20 April 2017 / Published: 26 April 2017

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Abstract

Background: Hyponatremia has been proposed as a contributor to falls in the elderly, which have become a major global issue with the aging of the population. This study aimed to assess the clinical presentation and outcomes of elderly patients with hyponatremia admitted

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Background: Hyponatremia has been proposed as a contributor to falls in the elderly, which have become a major global issue with the aging of the population. This study aimed to assess the clinical presentation and outcomes of elderly patients with hyponatremia admitted due to fall injuries in a Level I trauma center. Methods: We retrospectively reviewed data obtained from the Trauma Registry System for trauma admissions from January 2009 through December 2014. Hyponatremia was defined as a serum sodium level <135 mEq/L, and only patients who had sustained a fall at ground level (<1 m) were included. We used Chi-square tests, Student t-tests, and Mann-Whitney U tests to compare elderly patients (age ≥65 years) with hyponatremia (n = 492) to those without (n = 2002), and to adult patients (age 20–64 years) with hyponatremia (n = 125). Results: Significantly more elderly patients with hyponatremia presented to the emergency department (ED) due to falls compared to elderly patients without hyponatremia (73.7% vs. 52.6%; OR: 2.5, 95% CI: 2.10–3.02; p < 0.001). Elderly patients with hyponatremia presented with a worse outcome, measured by significantly higher odds of intubation (OR: 2.4, 95% CI: 1.15–4.83; p = 0.025), a longer in-hospital length of stay (LOS) (11 days vs. 9 days; p < 0.001), higher proportion of intensive care unit (ICU) admission (20.9% vs. 16.2%; OR: 1.4, 95% CI: 1.07–1.76; p = 0.013), and higher mortality (OR: 2.5, 95% CI: 1.53–3.96; p < 0.001), regardless of adjustment by Injury Severity Scores (ISS) (AOR: 2.4, 95% CI: 1.42–4.21; p = 0.001). Conclusions: Our results show that hyponatremia is associated with worse outcome from fall-related injuries in the elderly, with an increased ISS, longer LOS, and a higher risk of death. Full article

(This article belongs to the Section Global Health)

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Open AccessReview Pressure Injuries in Medically Complex Children: A Review

by Katherine Freundlich

Children 2017, 4(4), 25; doi:10.3390/children4040025

Received: 27 February 2017 / Revised: 29 March 2017 / Accepted: 3 April 2017 / Published: 7 April 2017

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Abstract

Pressure injuries are a challenging problem in the care of medically complex children. Available evidence is limited, and there are theoretical reasons to use caution before extrapolating adult data, including key differences in body composition, common locations of pressure injury, and association with

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Pressure injuries are a challenging problem in the care of medically complex children. Available evidence is limited, and there are theoretical reasons to use caution before extrapolating adult data, including key differences in body composition, common locations of pressure injury, and association with medical devices. The focus of this article will be to review the definition of a pressure injury and what is known about pathophysiology, prevention, recognition, staging, and treatment of pressure injuries in children with medical complexity. Full article

(This article belongs to the Special Issue Children with Complex Health Care Needs)

Open AccessArticle Unintentional Injuries and Violence among Adults in Northern Jordan: A Hospital-Based Retrospective Study

by Manal M. Alzghoul, Mohammed K. Shakhatreh and Nihaya Al-sheyab

Int. J. Environ. Res. Public Health 2017, 14(4), 343; doi:10.3390/ijerph14040343

Received: 27 February 2017 / Revised: 21 March 2017 / Accepted: 22 March 2017 / Published: 24 March 2017

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Abstract

Injuries (unintentional and intentional) are the main cause of death and disability worldwide, including Jordan. The main purpose of this hospital-based retrospective study was to identify characteristics, causes, and risk factors of unintentional injuries and violence among all adult patients who approached the

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Injuries (unintentional and intentional) are the main cause of death and disability worldwide, including Jordan. The main purpose of this hospital-based retrospective study was to identify characteristics, causes, and risk factors of unintentional injuries and violence among all adult patients who approached the Accidents and Emergency department because of injury in Northern Jordan. Data were collected retrospectively from four major hospitals from January 2008 to January 2013. A total of 2425 Jordanian individuals who accessed and were treated by the four hospitals were included in this study. The findings show that the majority of patients who approached the Accidents and Emergency departments in the four hospitals were males (n = 2044, 87.16%) versus females (n = 301, 12.8%). Violence was the most common reason of injury (70.66%), followed by road traffic crashes (23.21%). The most common anatomical locations of reported injuries were the head (38.74%), followed by abdomen/pelvis and lower back, among males and females (9.93%). Violence had a high significant effect on the site of injuries. Patients who had been injured to the head because of a stab wound or fighting were substantially over-involved in head injuries, with injury rates 3.88 and 7.51 times higher than those who had been injured to the head due to gunshot, respectively. Even patients who had been injured to the head because of assault show much higher involvement in injury risk than non-assault patients (Odds Ratio = 8.46). These findings highlight the need for a large national study to confirm the findings. It also draws attention to the importance of public awareness and to special injury prevention programs that not only focus on saving lives and lessening the number of injuries, illnesses, and fatalities, but also to limit the social and economic burden of injury among adults in Northern Jordan. Full article

(This article belongs to the Section Global Health)

Open AccessReview Effects of Melatonin on Liver Injuries and Diseases

by Jiao-Jiao Zhang, Xiao Meng, Ya Li, Yue Zhou, Dong-Ping Xu, Sha Li and Hua-Bin Li

Int. J. Mol. Sci. 2017, 18(4), 673; doi:10.3390/ijms18040673

Received: 9 January 2017 / Revised: 15 March 2017 / Accepted: 17 March 2017 / Published: 23 March 2017

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Abstract

Liver injuries and diseases are serious health problems worldwide. Various factors, such as chemical pollutants, drugs, and alcohol, could induce liver injuries. Liver diseases involve a wide range of liver pathologies, including hepatic steatosis, fatty liver, hepatitis, fibrosis, cirrhosis, and hepatocarcinoma. Despite all

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Liver injuries and diseases are serious health problems worldwide. Various factors, such as chemical pollutants, drugs, and alcohol, could induce liver injuries. Liver diseases involve a wide range of liver pathologies, including hepatic steatosis, fatty liver, hepatitis, fibrosis, cirrhosis, and hepatocarcinoma. Despite all the studies performed up to now, therapy choices for liver injuries and diseases are very few. Therefore, the search for a new treatment that could safely and effectively block or reverse liver injuries and diseases remains a priority. Melatonin is a well-known natural antioxidant, and has many bioactivities. There are numerous studies investigating the effects of melatonin on liver injuries and diseases, and melatonin could regulate various molecular pathways, such as inflammation, proliferation, apoptosis, metastasis, and autophagy in different pathophysiological situations. Melatonin could be used for preventing and treating liver injuries and diseases. Herein, we conduct a review summarizing the potential roles of melatonin in liver injuries and diseases, paying special attention to the mechanisms of action. Full article

(This article belongs to the Section Bioactives and Nutraceuticals)

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Open AccessArticle Nonfatal Injuries and Psychosocial Correlates among Middle School Students in Cambodia and Vietnam

by Karl Peltzer and Supa Pengpid

Int. J. Environ. Res. Public Health 2017, 14(3), 280; doi:10.3390/ijerph14030280

Received: 17 January 2017 / Accepted: 7 March 2017 / Published: 8 March 2017

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Abstract

The aim of the study was to estimate the prevalence and psychosocial correlates of nonfatal injury among middle school students in Cambodia and Vietnam. Cross-sectional data from 7137 school children (mean age 15.5 years, SD = 1.4) who were randomly sampled for participation

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The aim of the study was to estimate the prevalence and psychosocial correlates of nonfatal injury among middle school students in Cambodia and Vietnam. Cross-sectional data from 7137 school children (mean age 15.5 years, SD = 1.4) who were randomly sampled for participation in nationally representative Global School-based Health Surveys (GSHS) in Cambodia and Vietnam were analyzed. The proportion of school children reporting one or more serious injuries in the past year was 22.6% among boys and 17.5% among girls in Cambodia and 34.3% among boys and 25.1% among girls in Vietnam. The most prevalent cause of the most serious injury in Cambodia was traffic injuries (4.7% among boys and 4.3% among girls) and in Vietnam it was falls (10.0% among boys and 7.0% among girls). In multinomial logistic regression analyses, experiencing hunger (as an indicator for low socioeconomic status) and drug use were associated with having sustained one injury and two or more injuries in the past 12 months in Cambodia. In addition, poor mental health was associated with two or more injuries. In Vietnam, being male, experiencing hunger, current alcohol use, poor mental health and ever having had sex were associated with having sustained one injury and two or more injuries in the past 12 months. Several psychosocial variables were identified which could help in designing injury prevention strategies among middle school children in Cambodia and Vietnam. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

Open AccessArticle Variation in Incidence and Severity of Injuries among Crown-of-Thorns Starfish (Acanthaster cf. solaris) on Australia’s Great Barrier Reef

by Vanessa Messmer, Morgan Pratchett and Karen Chong-Seng

Diversity 2017, 9(1), 12; doi:10.3390/d9010012

Received: 8 December 2016 / Accepted: 10 February 2017 / Published: 21 February 2017

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Abstract

Despite the presence of numerous sharp poisonous spines, adult crown-of-thorns starfish (CoTS) are vulnerable to predation, though the importance and rates of predation are generally unknown. This study explores variation in the incidence and severity of injuries for Acanthaster cf. solaris from Australia’s

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Despite the presence of numerous sharp poisonous spines, adult crown-of-thorns starfish (CoTS) are vulnerable to predation, though the importance and rates of predation are generally unknown. This study explores variation in the incidence and severity of injuries for Acanthaster cf. solaris from Australia’s Great Barrier Reef. The major cause of such injuries is presumed to be sub-lethal predation such that the incidence of injuries may provide a proxy for overall predation and mortality rates. A total of 3846 Acanthaster cf. solaris were sampled across 19 reefs, of which 1955 (50.83%) were injured. Both the incidence and severity of injuries decreased with increasing body size. For small CoTS (<125 mm total diameter) >60% of individuals had injuries, and a mean 20.7% of arms (±2.9 SE) were affected. By comparison, <30% of large (>450 mm total diameter) CoTS had injuries, and, among those, only 8.3% of arms (±1.7 SE) were injured. The incidence of injuries varied greatly among reefs but was unaffected by the regulations of local fisheries. Full article

(This article belongs to the Special Issue Biology, Ecology and Management of Crown-of-Thorns Starfish)

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Open AccessArticle Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers

by Sungmin Lee, Chanam Lee and Susan Rodiek

Int. J. Environ. Res. Public Health 2017, 14(2), 163; doi:10.3390/ijerph14020163

Received: 13 December 2016 / Revised: 27 January 2017 / Accepted: 4 February 2017 / Published: 8 February 2017

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Abstract

Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS). Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed

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Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS). Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 2011 to 2014 involving adults aged 65 and older in the city of San Antonio (TX, USA) were analyzed at the census tract level (n = 264). Negative binomial regression was used to identify significant census tract-based neighborhood environmental variables associated with the count of fall injuries in each census tract. Adjusting for exposure variable and the size of the census tract, neighborhoods with higher residential stability, captured as the percent of those who lived in the same house as the previous year were associated with decreased count of fall injuries. Neighborhoods with higher residential density and having a higher vacancy rate were associated with increased count of fall injuries. The study highlights the importance of stable and safe neighborhoods in reducing fall risks among older adults, which should be considered a prerequisite for promoting age-friendly environments. Full article

(This article belongs to the Special Issue Aging and Health Promotion)

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Open AccessArticle Demographic and Substance Use Factors Associated with Non-Violent Alcohol-Related Injuries among Patrons of Australian Night-Time Entertainment Districts

by Kerri Coomber, Richelle Mayshak, Shannon Hyder, Nicolas Droste, Ashlee Curtis, Amy Pennay, William Gilmore, Tina Lam, Tanya Chikritzhs and Peter G. Miller

Int. J. Environ. Res. Public Health 2017, 14(1), 75; doi:10.3390/ijerph14010075

Received: 6 December 2016 / Revised: 4 January 2017 / Accepted: 10 January 2017 / Published: 12 January 2017

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Abstract

This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews (n = 4016) were conducted around licensed venues in entertainment districts

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This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews (n = 4016) were conducted around licensed venues in entertainment districts of five Australian cities. Demographic factors associated with non-violent alcohol-related injuries were examined, including gender, age, and occupation. The association between substance use on the night of interview; blood alcohol concentration (BAC), pre-drinking, energy drink consumption, and illicit drug use; and experience of injury was also explored. Thirteen percent of participants reported an alcohol-related injury within the past three months. Respondents aged younger than 25 years were significantly more likely to report an alcohol-related injury. Further, a significant occupation effect was found indicating the rate of alcohol-related injury was lower in managers/professionals compared to non-office workers. The likelihood of prior alcohol-related injury significantly increased with BAC, and self-reported pre-drinking, energy drink, or illicit drug consumption on the night of interview. These findings provide an indication of the demographic and substance use-related associations with alcohol-related injuries and, therefore, potential avenues of population-level policy intervention. Policy responses to alcohol-related harm must also account for an assessment and costing of non-violent injuries. Full article

(This article belongs to the Special Issue Alcohol and Health)

Open AccessArticle Exploration of Pedestrian Head Injuries—Collision Parameter Relationships through a Combination of Retrospective Analysis and Finite Element Method

by Wenjun Liu, Sen Su, Jinlong Qiu, Yongyong Zhang and Zhiyong Yin

Int. J. Environ. Res. Public Health 2016, 13(12), 1250; doi:10.3390/ijerph13121250

Received: 30 August 2016 / Revised: 18 October 2016 / Accepted: 22 November 2016 / Published: 16 December 2016

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Abstract

There are a very limited number of reports concerning the relationship between pedestrian head injuries and collision parameters through a combination of statistical analysis methods and finite element method (FEM). This study aims to explore the characteristics of pedestrian head injuries in car–pedestrian

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There are a very limited number of reports concerning the relationship between pedestrian head injuries and collision parameters through a combination of statistical analysis methods and finite element method (FEM). This study aims to explore the characteristics of pedestrian head injuries in car–pedestrian collisions at different parameters by using the two means above. A retrospective analysis of pedestrian head injuries was performed based on detailed investigation data of 61 car–pedestrian collision cases. The head damage assessment parameters (head injury criterion (HIC), peak stress on the skull, maximal principal strain for the brain) in car–pedestrian simulation experiments with four contact angles and three impact velocities were obtained by FEM. The characteristics of the pedestrian head injuries were discussed by comparing and analyzing the statistical analysis results and finite element analysis results. The statistical analysis results demonstrated a significant difference in skull fractures, contusion and laceration of brain and head injuries on the abbreviated injury scale (AIS)3+ was found at different velocities (p < 0.05) and angles (p < 0.05). The simulation results showed that, in pedestrian head-to-hood impacts, the values of head damage assessment parameters increased with impact velocities. At the same velocity, these values from the impact on the pedestrian’s back were successively greater than on the front or the side. Furthermore, head injury reconstruction and prediction results of two selected cases were consistent with the real injuries. Overall, it was further spelled out that, for shorter stature pedestrians, increased head impact velocity results in greater head injury severity in car–pedestrian collision, especially in pedestrian head-to-hood impacts. Under a back impact, the head has also been found to be at greater damage risk for shorter stature pedestrians, which may have implications on automotive design and pedestrian protection research if prevention and treatment of these injuries is to be prioritized over head injuries under a front or side impact. Full article

(This article belongs to the Special Issue Traffic Safety and Injury Prevention)

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Open AccessArticle Preventive Effects of Safety Helmets on Traumatic Brain Injury after Work-Related Falls

by Sang Chul Kim, Young Sun Ro, Sang Do Shin and Joo Yeong Kim

Int. J. Environ. Res. Public Health 2016, 13(11), 1063; doi:10.3390/ijerph13111063

Received: 12 September 2016 / Revised: 20 October 2016 / Accepted: 25 October 2016 / Published: 29 October 2016

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Abstract

Introduction: Work-related traumatic brain injury (TBI) caused by falls is a catastrophic event that leads to disabilities and high socio-medical costs. This study aimed to measure the magnitude of the preventive effect of safety helmets on clinical outcomes and to compare the effect

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Introduction: Work-related traumatic brain injury (TBI) caused by falls is a catastrophic event that leads to disabilities and high socio-medical costs. This study aimed to measure the magnitude of the preventive effect of safety helmets on clinical outcomes and to compare the effect across different heights of fall. Methods: We collected a nationwide, prospective database of work-related injury patients who visited the 10 emergency departments between July 2010 and October 2012. All of the adult patients who experienced work-related fall injuries were eligible, excluding cases with unknown safety helmet use and height of fall. Primary and secondary endpoints were intracranial injury and in-hospital mortality. We calculated adjusted odds ratios (AORs) of safety helmet use and height of fall for study outcomes, and adjusted for any potential confounders. Results: A total of 1298 patients who suffered from work-related fall injuries were enrolled. The industrial or construction area was the most common place of fall injury occurrence, and 45.0% were wearing safety helmets at the time of fall injuries. The safety helmet group was less likely to have intracranial injury comparing with the no safety helmet group (the adjusted odds ratios (ORs) (95% confidence interval (CI)): 0.42 (0.24–0.73)), however, there was no statistical difference of in-hospital mortality between two groups (the adjusted ORs (95% CI): 0.83 (0.34–2.03). In the interaction analysis, preventive effects of safety helmet on intracranial injury were significant within 4 m height of fall. Conclusions: A safety helmet is associated with prevention of intracranial injury resulting from work-related fall and the effect is preserved within 4 m height of fall. Therefore, wearing a safety helmet can be an intervention for protecting fall-related intracranial injury in the workplace. Full article

Open AccessArticle Chores at Times of Fatal or Serious Injuries Associated with Tractor Overturns with and without Rollover Protection

by Henry P. Cole, Melvin L. Myers and Susan C. Westneat

Safety 2016, 2(3), 18; doi:10.3390/safety2030018

Received: 10 May 2016 / Revised: 27 August 2016 / Accepted: 1 September 2016 / Published: 19 September 2016

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Abstract

This study describes chores when farmers were either fatally or seriously injured and required emergency medical treatment as a result of overturns of tractors with or without rollover protective structures (ROPS). Data from the 2002 Kentucky Farm Tractor Overturn Survey were used for

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This study describes chores when farmers were either fatally or seriously injured and required emergency medical treatment as a result of overturns of tractors with or without rollover protective structures (ROPS). Data from the 2002 Kentucky Farm Tractor Overturn Survey were used for this study. The data were collected by a telephone survey of a population-based random sample of 6063 (7.98%) of Kentucky’s 76,017 farm operators as listed in the Kentucky Agricultural Statistics Service database. Of farm operators interviewed, 551 (9.1%) reported 603 overturns and 5512 (90.9%) reported no overturns in the history of their farm, covering a period from 1925 to February 2002. Only the latest overturn was considered to improve recall accuracy. In addition, since the 1925 to 1959 time period had only 49 (8.1%) of the overturns reported, (14 farmers did not provide the year of most recent overturn); only data from the 1960 to 2002 period (approximately 41 years) were used. After making these adjustments, incidents evaluated included 25 cases (one fatal and four serious nonfatal injuries) that involved ROPS-equipped tractor overturns and 88 cases (24 fatal and 64 serious nonfatal injuries) that involved non-ROPS tractor overturns. Chores at highest risk for tractor overturns were identified for which educational and ROPS retrofit interventions could be emphasized. The highest frequency of overturn-related fatalities and nonfatal injuries were associated with hay harvesting, rotary mowing, and on-farm travel chores. These three chores represented 68.2% of fatal events and 50.0% of permanent and 56.6% of temporary disability overturn incidents. Tragically, in countries such as India and China with emerging mechanization, a large majority of tractors are produced without ROPS that can be expected to result in the same overturn-related epidemic of deaths experienced in highly mechanized countries, despite evidence of the protection provided by ROPS. Full article

(This article belongs to the Special Issue Agricultural Safety and Health)

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Open AccessArticle Role of Winter Weather Conditions and Slipperiness on Tourists’ Accidents in Finland

by Élise Lépy, Sinikka Rantala, Antti Huusko, Pentti Nieminen, Marjo Hippi and Arja Rautio

Int. J. Environ. Res. Public Health 2016, 13(8), 822; doi:10.3390/ijerph13080822

Received: 27 April 2016 / Revised: 22 July 2016 / Accepted: 8 August 2016 / Published: 15 August 2016

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Abstract

(1) Background: In Finland, slippery snowy or icy ground surface conditions can be quite hazardous to human health during wintertime. We focused on the impacts of the variability in weather conditions on tourists’ health via documented accidents during the winter season in the

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(1) Background: In Finland, slippery snowy or icy ground surface conditions can be quite hazardous to human health during wintertime. We focused on the impacts of the variability in weather conditions on tourists’ health via documented accidents during the winter season in the Sotkamo area. We attempted to estimate the slipping hazard in a specific context of space and time focusing on the weather and other possible parameters, responsible for fluctuations in the numbers of injuries/accidents; (2) Methods: We used statistical distributions with graphical illustrations to examine the distribution of visits to Kainuu Hospital by non-local patients and their characteristics/causes; graphs to illustrate the distribution of the different characteristics of weather conditions; questionnaires and interviews conducted among health care and safety personnel in Sotkamo and Kuusamo; (3) Results: There was a clear seasonal distribution in the numbers and types of extremity injuries of non-local patients. While the risk of slipping is emphasized, other factors leading to injuries are evaluated; and (4) Conclusions: The study highlighted the clear role of wintery weather conditions as a cause of extremity injuries even though other aspects must also be considered. Future scenarios, challenges and adaptive strategies are also discussed from the viewpoint of climate change. Full article

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Open AccessArticle How Does the Severity of Injury Vary between Motorcycle and Automobile Accident Victims Who Sustain High-Grade Blunt Hepatic and/or Splenic Injuries? Results of a Retrospective Analysis

by Ting-Min Hsieh, Tsung-Cheng Tsai, Yueh-Wei Liu and Ching-Hua Hsieh

Int. J. Environ. Res. Public Health 2016, 13(7), 739; doi:10.3390/ijerph13070739

Received: 8 June 2016 / Revised: 13 July 2016 / Accepted: 19 July 2016 / Published: 21 July 2016

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Abstract

Background: High-grade blunt hepatic and/or splenic injuries (BHSI) remain a great challenge for trauma surgeons. The main aim of this study was to investigate the characteristics, mortality rates, and outcomes of high-grade BHSI in motorcyclists and car occupants hospitalized for treatment of

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Background: High-grade blunt hepatic and/or splenic injuries (BHSI) remain a great challenge for trauma surgeons. The main aim of this study was to investigate the characteristics, mortality rates, and outcomes of high-grade BHSI in motorcyclists and car occupants hospitalized for treatment of traumatic injuries in a Level I trauma center in southern Taiwan. Methods: High-grade BHSI are defined as grade III-VI blunt hepatic injuries and grade III-V blunt splenic injuries. This retrospective study reviewed the data of 101 motorcyclists and 32 car occupants who experienced a high-grade BHSI from 1 January 2011 to 31 December 2013. Two-sided Fisher’s exact or Pearson’s chi-square tests were used to compare categorical data, unpaired Student’s t-test was used to analyze normally distributed continuous data, and Mann–Whitney’s U test was used to compare non-normally distributed data. Results: In this study, the majority (76%, 101/133) of high-grade BHSI were due to motorcycle crashes. Car occupants had a significantly higher injury severity score (ISS; 26.8 ± 10.9 vs. 20.7 ± 10.4, respectively, p = 0.005) and organ injured score (OIS; 3.8 ± 1.0 vs. 3.4 ± 0.6, respectively, p = 0.033), as well as a significantly longer hospital length of stay (LOS; 21.2 days vs. 14.6 days, respectively, p = 0.038) than did motorcyclists. Car occupants with high-grade BHSI also had worse clinical presentations than their motorcyclist counterparts, including a significantly higher incidence of hypotension, hyperpnea, tube thoracostomy, blood transfusion >4 units, LOS in intensive care unit >5 days, and complications. However, there were no differences in the percentage of angiography or laparotomy performed or mortality rate between these two groups of patients. Conclusions: This study demonstrated that car occupants with high-grade BHSI were injured more severely, had a higher incidence of worse clinical presentation, had a longer hospital LOS, and had a higher incidence of complications than motorcyclists. The results also implied that specific attention should be paid to those car occupants with high-grade BHSI, whose critical condition should not be underestimated because of the concept that the patients within in a car are much safer. Full article

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Open AccessReview Childhood Injuries in Singapore: Can Local Physicians and the Healthcare System Do More to Confront This Public Health Concern?

by Alvin Cong Wei Ong, Sher Guan Low and Farhad Fakhrudin Vasanwala

Int. J. Environ. Res. Public Health 2016, 13(7), 718; doi:10.3390/ijerph13070718

Received: 15 April 2016 / Revised: 3 June 2016 / Accepted: 8 July 2016 / Published: 16 July 2016

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Abstract

Childhood injury is one of the leading causes of death globally. Singapore is no exception to this tragic fact, with childhood injuries accounting up to 37% of Emergency Department visits. Hence, it is important to understand the epidemiology and risk factors of childhood

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Childhood injury is one of the leading causes of death globally. Singapore is no exception to this tragic fact, with childhood injuries accounting up to 37% of Emergency Department visits. Hence, it is important to understand the epidemiology and risk factors of childhood injuries locally. A search for relevant articles published from 1996–2016 was performed on PubMed, Cochrane Library and Google Scholar using keywords relating to childhood injury in Singapore. The epidemiology, mechanisms of injury, risk factors and recommended prevention strategies of unintentional childhood injuries were reviewed and described. Epidemiological studies have shown that childhood injury is a common, preventable and significant public health concern in Singapore. Home injuries and falls are responsible for majority of the injuries. Injuries related to childcare products, playground and road traffic accidents are also important causes. Healthcare professionals and legislators play an important role in raising awareness and reducing the incidence of childhood injuries in Singapore. For example, despite legislative requirements for many years, the low usage of child restraint seats in Singapore is worrisome. Thus, greater efforts in public health education in understanding childhood injuries, coupled with more research studies to evaluate the effectiveness and deficiencies of current prevention strategies will be necessary. Full article

Open AccessArticle The Extent of Consumer Product Involvement in Paediatric Injuries

by Jesani Catchpoole, Sue Walker and Kirsten Vallmuur

Int. J. Environ. Res. Public Health 2016, 13(7), 654; doi:10.3390/ijerph13070654

Received: 26 February 2016 / Revised: 1 April 2016 / Accepted: 5 April 2016 / Published: 7 July 2016

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Abstract

A challenge in utilising health sector injury data for Product Safety purposes is that clinically coded data have limited ability to inform regulators about product involvement in injury events, given data entry is bound by a predefined set of codes. Text narratives collected

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A challenge in utilising health sector injury data for Product Safety purposes is that clinically coded data have limited ability to inform regulators about product involvement in injury events, given data entry is bound by a predefined set of codes. Text narratives collected in emergency departments can potentially address this limitation by providing relevant product information with additional accompanying context. This study aims to identify and quantify consumer product involvement in paediatric injuries recorded in emergency department-based injury surveillance data. A total of 7743 paediatric injuries were randomly selected from Queensland Injury Surveillance Unit database and associated text narratives were manually reviewed to determine product involvement in the injury event. A Product Involvement Factor classification system was used to categorise these injury cases. Overall, 44% of all reviewed cases were associated with consumer products, with proximity factor (25%) being identified as the most common involvement of a product in an injury event. Only 6% were established as being directly due to the product. The study highlights the importance of utilising injury data to inform product safety initiatives where text narratives can be used to identify the type and involvement of products in injury cases. Full article

(This article belongs to the Special Issue Child Injury Prevention 2015)

Open AccessArticle Economic Burden of Hospitalization Due to Injuries in North India: A Cohort Study

by Shankar Prinja, Jagnoor Jagnoor, Akashdeep Singh Chauhan, Sameer Aggarwal, Ha Nguyen and Rebecca Ivers

Int. J. Environ. Res. Public Health 2016, 13(7), 673; doi:10.3390/ijerph13070673

Received: 24 February 2016 / Revised: 23 June 2016 / Accepted: 27 June 2016 / Published: 2 July 2016

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Abstract

There is little documentation of the potential catastrophic effects of injuries on families due to out of pocket (OOP) expenditure for medical care. Patients who were admitted for at least one night in a tertiary care hospital of Chandigarh city due to injury

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There is little documentation of the potential catastrophic effects of injuries on families due to out of pocket (OOP) expenditure for medical care. Patients who were admitted for at least one night in a tertiary care hospital of Chandigarh city due to injury were recruited and were followed-up at 1, 2 and 12 months after discharge to collect information on OOP expenditure. Out of the total 227 patients, 60% (137/227) had sustained road traffic injuries (RTI). The average OOP expenditure per hospitalisation and up to 12 months post discharge was USD 388 (95% CI: 332–441) and USD 1046 (95% CI: 871–1221) respectively. Mean OOP expenditure for RTI and non-RTI cases during hospitalisation was USD 400 (95% CI: 344–456) and USD 369 (95% CI: 313–425) respectively. The prevalence of catastrophic expenditure was 30%, and was significantly higher among those belonging to the lowest income quartile (OR-26.50, 95% CI: 6.70–105.07, p-value: <0.01) and with an inpatient stay greater than 7 days (OR-10.60, 95% CI: 4.21–26.64, p-value: <0.01). High OOP expenditure for treatment of injury puts a significant economic burden on families. Measures aimed at increasing public health spending for prevention of injury and providing financial risk protection are urgently required in India. Full article

(This article belongs to the Section Health Services and Health Economics Research)

Open AccessArticle Penile Injuries in Wild and Domestic Pigs

by Ulrike Weiler, Marie Isernhagen, Volker Stefanski, Mathias Ritzmann, Kevin Kress, Charlotte Hein and Susanne Zöls

Animals 2016, 6(4), 25; doi:10.3390/ani6040025

Received: 11 February 2016 / Revised: 14 March 2016 / Accepted: 16 March 2016 / Published: 25 March 2016

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Abstract

In boars, sexually motivated mounting can not only cause problems such as lameness, but penile injuries are also reported. The relevance of penis biting in boars is discussed controversially, but reliable data is missing. In the present study, boars (n = 385)

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In boars, sexually motivated mounting can not only cause problems such as lameness, but penile injuries are also reported. The relevance of penis biting in boars is discussed controversially, but reliable data is missing. In the present study, boars (n = 385) and barrows (n = 85) from experimental farms were therefore evaluated for scars, fresh wounds and severe injuries of the penis. Similarly, 321 boars from 11 farms specializing in pork production with boars, and 15 sexually mature wild boars from the hunting season of 2015/16 were included in the study. In domestic boars, a high incidence of penile injuries was obvious (76.6%–91.3% of animals with scars and/or wounds at experimental farms, 64.0%–94.9% at commercial farms). The number of boars with severe injuries was in a similar range in both groups (5.2% vs. 9.3%). At commercial farms, the number of scars but not that of fresh wounds increased per animal with age by 0.3 per week. Moreover, raising boars in mixed groups led to about a 1.5 times higher number of scars than in single-sex groups. In wild boars, a considerable proportion of animals (40%) revealed penile injuries, which were even severe in three animals. We therefore conclude that penis biting is a highly relevant and severe welfare problem in the male pig population, but this phenomenon is not limited to intensive production systems. Full article

Open AccessArticle In Vivo Effects of Quercetin in Association with Moderate Exercise Training in Improving Streptozotocin-Induced Aortic Tissue Injuries

by Irina C. Chis, Andrei Coseriu, Ramona Simedrea, Adrian Oros, Andras L. Nagy and Simona Clichici

Molecules 2015, 20(12), 21770-21786; doi:10.3390/molecules201219802

Received: 24 October 2015 / Revised: 26 November 2015 / Accepted: 30 November 2015 / Published: 4 December 2015

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Abstract

Background: Diabetes mellitus (DM) is a chronic endocrine-metabolic disorder associated with endothelial dysfunction. Hyperglycemia, dyslipidemia and abnormal nitric oxide-mediated vasodilatation are the major causal factors in the development of endothelial dysfunction in DM. The prevention of endothelial dysfunction may be a first target

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Background: Diabetes mellitus (DM) is a chronic endocrine-metabolic disorder associated with endothelial dysfunction. Hyperglycemia, dyslipidemia and abnormal nitric oxide-mediated vasodilatation are the major causal factors in the development of endothelial dysfunction in DM. The prevention of endothelial dysfunction may be a first target against the appearance of atherosclerosis and cardiovascular diseases. We have investigated the synergistic protective effects of quercetin administration and moderate exercise training on thoracic aorta injuries induced by diabetes. Methods: Diabetic rats that performed exercise training were subjected to a swimming training program (1 h/day, 5 days/week, 4 weeks). The diabetic rats received quercetin (30 mg/kg body weight/day) for 4 weeks. At the end of the study, the thoracic aorta was isolated and divided into two parts; one part was immersed in 10% formalin for histopathological evaluations and the other was frozen for the assessment of oxidative stress markers (malondialdehyde, MDA and protein carbonyls groups, PC), the activity of antioxidant enzymes (superoxide dismutase, SOD and catalase, CAT), nitrite plus nitrate (NOx) production and inducible nitric oxide synthase (iNOS) protein expression. Results: Diabetic rats showed significantly increased MDA and PC levels, NOx production and iNOS expression and a reduction of SOD and CAT activity in aortic tissues. A decrease in the levels of oxidative stress markers, NOx production and iNOS expression associated with elevated activity of antioxidant enzymes in the aortic tissue were observed in quercetin-treated diabetic trained rats. Conclusions: These findings suggest that quercetin administration in association with moderate exercise training reduces vascular complications and tissue injuries induced by diabetes in rat aorta by decreasing oxidative stress and restoring NO bioavailability. Full article

(This article belongs to the Special Issue New Frontiers on the Metabolism, Bioavailability and Health Effects of Phenolic Compounds)

Open AccessArticle Epidemiology of Unintentional Child Injuries in the Makwanpur District of Nepal: A Household Survey

by Puspa Raj Pant, Elizabeth Towner, Matthew Ellis, Dharma Manandhar, Paul Pilkington and Julie Mytton

Int. J. Environ. Res. Public Health 2015, 12(12), 15118-15128; doi:10.3390/ijerph121214967

Received: 7 October 2015 / Revised: 20 November 2015 / Accepted: 23 November 2015 / Published: 30 November 2015

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Abstract

Secondary sources of information indicate that the proportion of child deaths due to injuries is increasing in Nepal. This study aimed to describe the epidemiology of unintentional injuries in children, explore risk factors and estimate the burden faced by families and the community

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Secondary sources of information indicate that the proportion of child deaths due to injuries is increasing in Nepal. This study aimed to describe the epidemiology of unintentional injuries in children, explore risk factors and estimate the burden faced by families and the community in the Makwanpur district. We conducted a household survey in Makwanpur, covering 3441 households. Injuries that occurred during the 12 months before the survey and required treatment or caused the child to be unable to take part in usual activities for three or more days were included. We identified 193 cases of non-fatal unintentional child injuries from 181 households and estimated an annual rate of non-fatal injuries of 24.6/1000 children; rates for boys were double (32.7/1000) that for girls (16.8/1000). The rates were higher among the children of age groups 1–4 years and 5–9 years. Falls were the most common cause of non-fatal child injuries followed by burns in preschool children and road traffic injuries were the most likely cause in adolescence. Mean period of disability following injury was 25 days. The rates and the mechanisms of injury vary by age and gender. Falls and burns are currently the most common mechanisms of injury amongst young children around rural homes. Full article

(This article belongs to the Special Issue Child Injury Prevention 2015)

Open AccessArticle A Cross-Sectional Study of Horse-Related Injuries in Veterinary and Animal Science Students at an Australian University

by Christopher B. Riley, Jessica R. Liddiard and Kirrilly Thompson

Animals 2015, 5(4), 951-964; doi:10.3390/ani5040392

Received: 30 July 2015 / Revised: 15 September 2015 / Accepted: 18 September 2015 / Published: 25 September 2015

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Abstract

Specific estimates of the risk of horse-related injury (HRI) to university students enrolled in veterinary and animal sciences have not been reported. This study aimed to determine the risk of student HRI during their university education, the nature and management of such injuries.

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Specific estimates of the risk of horse-related injury (HRI) to university students enrolled in veterinary and animal sciences have not been reported. This study aimed to determine the risk of student HRI during their university education, the nature and management of such injuries. A retrospective questionnaire solicited demographic information, data on students’ equine experience prior to and during their educational programs, and on HRI during their program of study. Of 260 respondents, 22 (8.5%) reported HRI (27 incidents). Including concurrent injuries the most commonly injured body parts were the foot or ankle (nine of 32 injures), the upper leg or knee (eight of 32), and hands (three of 32). Trampling and being kicked by a hind limb were each associated with 30.4% of HRI, and 13% with being bitten. Bruising (91.3% of respondents) and an open wound (17.4%) were most commonly described. No treatment occurred for 60.9% of incidents; professional medical treatment was not sought for the remainder. Most incidents (56.5%) occurred during program-related work experience placements. Although injury rates and severity were modest, a proactive approach to injury prevention and reporting is recommended for students required to handle horses as part of their education. Student accident and injury data should be monitored to ensure effective evaluation of risk-reduction initiatives. The risk and nature of university student horse-related injury (HRI) was studied. Of 260 students, 22 (8.5%) reported HRI (27 incidents). Including multiple injuries, reports described involvement of the foot or ankle (nine of 32 injures), upper leg or knee (eight of 32), and hands (three of 32). Trampling (30.4%) and being kicked (30.4%) accounted for most HRI. The injuries were usually bruising (91.3%) or an open wound (17.4%). Most (60.9%) injuries were untreated; professional medical treatment was not sought for the rest. Most incidents (56.5%) occurred during program-related off-campus work experiences. A proactive approach to injury prevention is recommended for students handling horses. Full article

(This article belongs to the Special Issue Horses and Risk)

Open AccessArticle Maternal PUFA ω-3 Supplementation Prevents Neonatal Lung Injuries Induced by Hyperoxia in Newborn Rats

by Dyuti Sharma, Armande Subayi Nkembi, Estelle Aubry, Ali Houeijeh, Laura Butruille, Véronique Houfflin-Debarge, Rémi Besson, Philippe Deruelle and Laurent Storme

Int. J. Mol. Sci. 2015, 16(9), 22081-22093; doi:10.3390/ijms160922081

Received: 30 June 2015 / Revised: 27 July 2015 / Accepted: 7 September 2015 / Published: 14 September 2015

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Abstract

Bronchopulmonary dysplasia (BPD) is one of the most common complications of prematurity, occurring in 30% of very low birth weight infants. The benefits of dietary intake of polyunsaturated fatty acids ω-3 (PUFA ω-3) during pregnancy or the perinatal period have been reported. The

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Bronchopulmonary dysplasia (BPD) is one of the most common complications of prematurity, occurring in 30% of very low birth weight infants. The benefits of dietary intake of polyunsaturated fatty acids ω-3 (PUFA ω-3) during pregnancy or the perinatal period have been reported. The aim of this study was to assess the effects of maternal PUFA ω-3 supplementation on lung injuries in newborn rats exposed to prolonged hyperoxia. Pregnant female Wistar rats (n = 14) were fed a control diet (n = 2), a PUFA ω-6 diet (n = 6), or a PUFA ω-3 diet (n = 6), starting with the 14th gestation day. At Day 1, female and newborn rats (10 per female) were exposed to hyperoxia (O₂, n = 70)or to the ambient air (Air, n = 70). Six groups of newborns rats were obtained: PUFA ω-6/O₂ (n = 30), PUFA ω-6/air (n = 30), PUFA ω-3/O₂ (n = 30), PUFA ω-3/air (n = 30), control/O₂ (n = 10), and control/air (n = 10). After 10 days, lungs were removed for analysis of alveolarization and pulmonary vascular development. Survival rate was 100%. Hyperoxia reduced alveolarization and increased pulmonary vascular wall thickness in both control (n = 20) and PUFA ω-6 groups (n = 60). Maternal PUFA ω-3 supplementation prevented the decrease in alveolarization caused by hyperoxia (n = 30) compared to PUFA ω-6/O₂ (n = 30) or to the control/O₂ (n = 10), but did not significantly increase the thickness of the lung vascular wall. Therefore, maternal PUFA ω-3 supplementation may protect newborn rats from lung injuries induced by hyperoxia. In clinical settings, maternal PUFA ω-3 supplementation during pregnancy and during lactation may prevent BPD development after premature birth. Full article

(This article belongs to the Special Issue Omega-3 Fatty Acids in Health and Diseases)

Open AccessArticle Workplace Injuries in Thoroughbred Racing: An Analysis of Insurance Payments and Injuries amongst Jockeys in Australia from 2002 to 2010

by Beverley A. Curry, Peta L. Hitchens, Petr Otahal, Lei Si and Andrew J. Palmer

Animals 2015, 5(3), 897-909; doi:10.3390/ani5030390

Received: 2 June 2015 / Accepted: 28 August 2015 / Published: 8 September 2015

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Abstract

Background: There is no comprehensive study of the costs of horse-related workplace injuries to Australian Thoroughbred racing jockeys. Objectives: To analyse the characteristics of insurance payments and horse-related workplace injuries to Australian jockeys during Thoroughbred racing or training. Methods: Insurance

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Background: There is no comprehensive study of the costs of horse-related workplace injuries to Australian Thoroughbred racing jockeys. Objectives: To analyse the characteristics of insurance payments and horse-related workplace injuries to Australian jockeys during Thoroughbred racing or training. Methods: Insurance payments to Australian jockeys and apprentice jockeys as a result of claims for injury were reviewed. The cause and nature of injuries, and the breakdown of payments associated with claims were described. Results: The incidence of claims was 2.1/1000 race rides, with an average cost of AUD 9 million/year. Race-day incidents were associated with 39% of claims, but 52% of the total cost. The mean cost of race-day incidents (AUD 33,756) was higher than non-race day incidents (AUD 20,338). Weekly benefits and medical expenses made up the majority of costs of claims. Fractures were the most common injury (29.5%), but head injuries resulting from a fall from a horse had the highest mean cost/claim (AUD 127,127). Conclusions: Costs of workplace injuries to the Australian Thoroughbred racing industry have been greatly underestimated because the focus has historically been on incidents that occur on race-days. These findings add to the evidence base for developing strategies to reduce injuries and their associated costs. Full article

(This article belongs to the Special Issue Horses and Risk)

Open AccessArticle Injuries among Artisanal and Small-Scale Gold Miners in Ghana

by E. Kyeremateng-Amoah and Edith E. Clarke

Int. J. Environ. Res. Public Health 2015, 12(9), 10886-10896; doi:10.3390/ijerph120910886

Received: 30 June 2015 / Revised: 20 August 2015 / Accepted: 27 August 2015 / Published: 2 September 2015

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Abstract

Artisanal and small-scale gold miners are confronted with numerous hazards often resulting in varying degrees of injuries and fatalities. In Ghana, like many developing countries, there is paucity of information on the causes and nature of the accidents that result in the injuries.

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Artisanal and small-scale gold miners are confronted with numerous hazards often resulting in varying degrees of injuries and fatalities. In Ghana, like many developing countries, there is paucity of information on the causes and nature of the accidents that result in the injuries. The study was a retrospective, cross sectional type that examined the records of injuries of artisanal and small-scale gold miners presented to the emergency department of a district hospital in the Eastern Region of Ghana from 2006 to 2013. The causes, types, and outcomes of reported injuries were analyzed for 72 cases. Occurrences of mining accidents reported in selected Ghanaian media during the year 2007–2012 were also analyzed to corroborate the causes of the accidents. Fractures and contusions constituted the most frequently occurring injuries, with collapse of the mine pits and falls being the most frequent cause of accidents reported both by the hospital and media records. This study shows that though varied degrees of injuries occur among the miners, the potential for serious injuries is substantial. Measures to reduce the incidence of injuries and fatalities should include education and training on the use of safe working tools and means of creating a safe working environment. Full article

(This article belongs to the Special Issue Integrated Assessment of Artisanal and Small-Scale Gold Mining (ASGM) in Ghana)

Open AccessArticle Epidemiological Characteristics of Work-Related Ocular Trauma in Southwest Region of China

by Mingming Cai and Jie Zhang

Int. J. Environ. Res. Public Health 2015, 12(8), 9864-9875; doi:10.3390/ijerph120809864

Received: 27 May 2015 / Revised: 31 July 2015 / Accepted: 11 August 2015 / Published: 19 August 2015

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Abstract

Purpose: To determine the epidemiological characteristics of work-related eye injury in representative southwest region of China. Methods: Patients with eye injuries treated at the Ninth People’s Hospital of Chongqing from 1 January 2014 to 31 December 2014 were included in the

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Purpose: To determine the epidemiological characteristics of work-related eye injury in representative southwest region of China. Methods: Patients with eye injuries treated at the Ninth People’s Hospital of Chongqing from 1 January 2014 to 31 December 2014 were included in the current study. All patients completed a comprehensive examination and interview. Demographic characteristics and injury details were recorded. The International Classification of Diseases (ICD-10) and Birmingham Eye Trauma Terminology (BETT) were used. Results: The average age of eye injury patients was 37.52 years and the majority were male. Among the 1055 total patients, approximately 42.9% of the injuries were work-related. The highest proportion of occupational eye trauma was observed in the group between 36 and 45 years of age. Occupational ocular trauma occurred more frequently in summer, with most from 16:00 to 18:00. Metal was the most common injury cause. Foreign body on external eye was the most common diagnosis. Workers in the manufacturing industry without pre-work safety training or eye protection were far more likely to suffer from occupational ocular trauma than those with training and protection. Conclusions: This study provides insight into the epidemiological characteristics of occupational ocular trauma in southwest region of China. The current findings might be considered as a baseline for future research on regional work-related eye injuries. Our findings will provide valuable information for further development of preventive strategies. Full article

(This article belongs to the Special Issue Occupational Safety and Related Impacts on Health and the Environment)

Open AccessArticle Injury Profiles Associated with Artisanal and Small-Scale Gold Mining in Tarkwa, Ghana

by Benedict N. L. Calys-Tagoe, Lauretta Ovadje, Edith Clarke, Niladri Basu and Thomas Robins

Int. J. Environ. Res. Public Health 2015, 12(7), 7922-7937; doi:10.3390/ijerph120707922

Received: 16 May 2015 / Revised: 6 July 2015 / Accepted: 8 July 2015 / Published: 10 July 2015

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Abstract

Artisanal and small-scale gold mining (ASGM) is inherently risky, but little is known about mining-associated hazards and injuries despite the tremendous growth worldwide of ASGM and the benefits it offers. The current study aimed to characterize the physical injuries associated with ASGM in

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Artisanal and small-scale gold mining (ASGM) is inherently risky, but little is known about mining-associated hazards and injuries despite the tremendous growth worldwide of ASGM and the benefits it offers. The current study aimed to characterize the physical injuries associated with ASGM in Ghana to guide policy formulation. A cross-sectional survey was carried out in the Tarkwa mining district of the Western Region of Ghana in 2014. A total of 404 small-scale miners were recruited and interviewed regarding their occupational injury experiences over the preceding 10 years using a paper-based structured questionnaire. Nearly one-quarter (23.5%) of the miners interviewed reported getting injured over the previous 10 years, and the overall injury rate was calculated to be 5.39 per 100 person years. The rate was significantly higher for women (11.93 per 100 person years) and those with little mining experience (e.g., 25.31 per 100 person years for those with less than one year of work experience). The most injury-prone mining activities were excavation (58.7%) and crushing (23.1%), and over 70% of the injuries were reported to be due to miners being hit by an object. The majority of the injuries (57%) were lacerations, and nearly 70% of the injuries were to the upper or lower limbs. Approximately one-third (34.7%) of the injuries resulted in miners missing more than two weeks of work. One-quarter of the injured workers believed that abnormal work pressure played a role in their injuries, and nearly two-fifths believed that their injuries could have been prevented, with many citing personal protective equipment as a solution. About one-quarter of the employees reported that their employers never seemed to be interested in the welfare or safety of their employees. These findings greatly advance our understanding of occupational hazards and injuries amongst ASGM workers and help identify several intervention points. Full article

(This article belongs to the Special Issue Integrated Assessment of Artisanal and Small-Scale Gold Mining (ASGM) in Ghana)

Open AccessProject Report A Retrospective Review from 2006 to 2011 of Lower Extremity Injuries in Badminton in New Zealand

by Joanna Reeves, Patria A. Hume, Simon Gianotti, Barry Wilson and Erika Ikeda

Sports 2015, 3(2), 77-86; doi:10.3390/sports3020077

Received: 8 March 2015 / Accepted: 6 June 2015 / Published: 12 June 2015

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Abstract

Aim: To describe lower extremity injuries for badminton in New Zealand. Methods: Lower limb badminton injuries that resulted in claims accepted by the national insurance company Accident Compensation Corporation (ACC) in New Zealand between 2006 and 2011 were reviewed. Results: The estimated national

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Aim: To describe lower extremity injuries for badminton in New Zealand. Methods: Lower limb badminton injuries that resulted in claims accepted by the national insurance company Accident Compensation Corporation (ACC) in New Zealand between 2006 and 2011 were reviewed. Results: The estimated national injury incidence for badminton injuries in New Zealand from 2006 to 2011 was 0.66%. There were 1909 lower limb badminton injury claims which cost NZ$2,014,337 (NZ$ value over 2006 to 2011). The age-bands frequently injured were 10–19 (22%), 40–49 (22%), 30–39 (14%) and 50–59 (13%) years. Sixty five percent of lower limb injuries were knee ligament sprains/tears. Males sustained more cruciate ligament sprains than females (75 vs. 39). Movements involving turning, changing direction, shifting weight, pivoting or twisting were responsible for 34% of lower extremity injuries. Conclusion: The knee was most frequently injured which could be due to multi-planar loading. Turning or cutting movements typically involve motion in the frontal and transverse planes that may place the knee at greater risk of injury than movement in the sagittal plane alone. Further research on badminton specific movements is warranted to better understand the mechanisms of lower extremity injuries in the sport. Sports medicine and support personnel should take into account the susceptibility of the knee to injury when designing training and injury prevention programmes given the large number of change of direction movements during badminton. Full article

(This article belongs to the Special Issue Sports Medicine)

Open AccessArticle Effect of a Multi-Level Education Intervention Model on Knowledge and Attitudes of Accidental Injuries in Rural Children in Zunyi, Southwest China

by Bo-Ling Cao, Xiu-Quan Shi, Yong-Hong Qi, Ya Hui, Hua-Jun Yang, Shang-Peng Shi, Li-Rong Luo, Hong Zhang, Xin Wang and Ying-Ping Yang

Int. J. Environ. Res. Public Health 2015, 12(4), 3903-3914; doi:10.3390/ijerph120403903

Received: 14 January 2015 / Revised: 26 March 2015 / Accepted: 30 March 2015 / Published: 8 April 2015

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Abstract

Objective: To explore the effect of a school-family-individual (SFI) multi-level education intervention model on knowledge and attitudes about accidental injuries among school-aged children to improve injury prevention strategies and reduce the incidence of pediatric injuries. Methods: The random sample of rural

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Objective: To explore the effect of a school-family-individual (SFI) multi-level education intervention model on knowledge and attitudes about accidental injuries among school-aged children to improve injury prevention strategies and reduce the incidence of pediatric injuries. Methods: The random sample of rural school-aged children were recruited by using a multistage, stratified, cluster sampling method in Zunyi, Southwest China from 2012 to 2014, and 2342 children were randomly divided into intervention and control groups. Then children answered a baseline survey to collect knowledge and attitude scores (KAS) of accidental injuries. In the intervention group, children, their parents/guardians and the school received a SFI multi-level education intervention, which included a children’s injury-prevention poster at schools, an open letter about security instruction for parents/guardians and multiple-media health education (Microsoft PowerPoint lectures, videos, handbooks, etc.) to children. Children in the control group were given only handbook education. After 16 months, children answered a follow-up survey to collect data on accidental injury types and accidental injury-related KAS for comparing the intervention and control groups and baseline and follow-up data. Results: The distribution of gender was not significantly different while age was different between the baseline and follow-up survey. At baseline, the mean KAS was lower for the intervention than control group (15.37 ± 3.40 and 18.35 ± 5.01; p < 0.001). At follow-up, the mean KAS was higher for the intervention than control group (21.16 ± 3.05 and 20.02 ± 3.40; p < 0.001). The increase in KAS in the intervention and control groups was significant (p < 0.001; KAS: 5.79 vs. 1.67) and suggested that children’s injury-related KAS improved in the intervention group. Moreover, the KAS between the groups differed for most subtypes of incidental injuries (based on International Classification of Diseases 10, ICD-10) (p < 0.05). Before intervention, 350 children had reported their accident injury episodes, while after intervention 237 children had reported their accidental injury episodes in the follow-up survey. Conclusions: SFI multi-level education intervention could significantly increase KAS for accidental injuries, which should improve children’s prevention-related knowledge and attitudes about such injuries. It should help children change their risk behaviors and reduce the incidence of accidental injuries. Our results highlight a new intervention model of injury prevention among school-aged children. Full article

Open AccessReview Epidemiological Review of Injuries in Rugby Union

by Jean-François Kaux, Marc Julia, François Delvaux, Jean-Louis Croisier, Bénédicte Forthomme, Damien Monnot, Marie Chupin, Jean-Michel Crielaard, Caroline Le Goff, Patrick Durez, Philippe Ernst, Sébastien Guns and Arnaud Laly

Sports 2015, 3(1), 21-29; doi:10.3390/sports3010021

Received: 21 November 2013 / Accepted: 14 January 2015 / Published: 23 January 2015

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Abstract

Rugby is a sport that is growing in popularity. A contact sport par excellence, it causes a significant number of injuries. In Rugby Union, there are 30 to 91 injuries per 1000 match hours. This epidemiological review of injuries incurred by rugby

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Rugby is a sport that is growing in popularity. A contact sport par excellence, it causes a significant number of injuries. In Rugby Union, there are 30 to 91 injuries per 1000 match hours. This epidemiological review of injuries incurred by rugby players mentions the position and type of injuries, the causes, time during the match and season in which they occur and the players’ positions as well as the length of players’ absences following the injury. Full article

(This article belongs to the Special Issue Sports Medicine)

Open AccessArticle Sleep-Related Factors and Work-Related Injuries among Farmers in Heilongjiang Province, People’s Republic of China

by Huiping Zhu, Yunfeng Han, Yaowu Sun, Zhiping Xie, Xueyan Qian, Lorann Stallones, Huiyun Xiang and Limin Wang

Int. J. Environ. Res. Public Health 2014, 11(9), 9446-9459; doi:10.3390/ijerph110909446

Received: 9 May 2014 / Revised: 27 June 2014 / Accepted: 9 July 2014 / Published: 11 September 2014

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Abstract

The association between sleep and work-related injuries among Chinese farmers has not been well studied. This study examined the impact of lack of sleep on agricultural work-related injuries among farmers in China. Data were from a cross-sectional survey of farm-workers in northeastern China.

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The association between sleep and work-related injuries among Chinese farmers has not been well studied. This study examined the impact of lack of sleep on agricultural work-related injuries among farmers in China. Data were from a cross-sectional survey of farm-workers in northeastern China. Information was obtained on injuries that occurred in 12 months prior to the survey, on eight sleep-related variables, and on socio-demographic variables. Logistic regression analyses were conducted to test the hypothesis that lack of sleep significantly increased the risk of work-related injuries after controlling for other injury-related risk- factors. Farmers who slept less than six hours per night were 59% more likely to be injured than those who slept more than eight hours per night (OR = 1.59; 95% CI = 1.04, 2.41). The odds of a work-related injury was 2.46 (1.56–3.89) for farmers who reported going to sleep after midnight at least once a week compared with farmers who reported going to sleep after midnight once a month. Farmers who reported having difficulty falling asleep or waking frequently during the night, who often having nightmares, or who experienced daytime sleepiness were at higher injury risk compared with the reference group after controlling for age, gender and alcohol consumption. Reduced sleep hours and poor sleep quality significantly increased the risk of work-related injuries in Chinese farmers. Sleep hours and sleep quality should be considered when assessing occupational safety among farmers. Full article

Open AccessArticle Epidemiological Risk Analysis of Home Injuries in Italy (1999–2006)

by Pierpaolo Ferrante, Alessandro Marinaccio and Sergio Iavicoli

Int. J. Environ. Res. Public Health 2014, 11(4), 4402-4416; doi:10.3390/ijerph110404402

Received: 7 January 2014 / Revised: 2 April 2014 / Accepted: 3 April 2014 / Published: 22 April 2014

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Abstract

Home injuries are an important public health issue in both developed and developing countries. This study focused on the Italian epidemiological framework between 1999 and 2006, using a nation-representative sample provided by the National Institute of Statistics. Every year, about 3,000,000 Italian residents

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Home injuries are an important public health issue in both developed and developing countries. This study focused on the Italian epidemiological framework between 1999 and 2006, using a nation-representative sample provided by the National Institute of Statistics. Every year, about 3,000,000 Italian residents reported at least one home injury, with an overall annual rate of 5.2/100 (95% CI 5.1–5.4); 3.2/100 (3.0–3.4) for males and 7.2/100 (6.9–7.4) for females. Poisson regression models were used for different age-specific populations (children, young/adults and older people), to evaluate the effects of socio-demographic, health/income satisfaction and housing variables. For children, non-applicable variables (including smoking and health satisfaction) were taken as those of the head of family, while housework time was taken the family mean time. Evidence of decreasing time trend in risk of home injury was found only among young/adults (p < 0.01). The following were risk factors: female gender (adjusted relative risk—RR 2.0 for older people and RR 1.9 for young/adults, p < 0.01); one additional hour of work at home (RR 1.009, p < 0.01 for young/adults and RR 1.016, p = 0.01 for children); smoking (RR 1.3, p < 0.01 for young/adults and p = 0.02 for children); health dissatisfaction (RR 1.3, p = 0.05 for children, RR 1.6 for young/adults and RR 1.7 for older people, p < 0.01); income dissatisfaction (RR 1.2, p < 0.01 for young/adults ); living alone (RR 1.5, p < 0.01 for young/adults and RR 1.2, p < 0.02 for the older people); having a garden (RR 1.1, p < 0.01 for young/adults ). Awareness of the need for safety at home could be boosted by information campaigns on the risk, and its social cost could be reduced by specific prevention schemes. Developing tools for assessing the risk at home and for removing the main hazards would be useful for both informative and prevention interventions. Full article

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Open AccessArticle Motor Vehicle Accident Eye Injuries in Northern Israel

by Michael Yulish and Joseph Pikkel

Int. J. Environ. Res. Public Health 2014, 11(4), 4311-4315; doi:10.3390/ijerph110404311

Received: 2 March 2014 / Revised: 4 April 2014 / Accepted: 8 April 2014 / Published: 17 April 2014

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Abstract

Purpose: To investigate the occurrence and types of motor vehicle accident eye trauma in north Israel. Methods: The records between the years 2007–2011 of the Ophthalmology Emergency Room of one medical center were searched. Eye injuries due to motor vehicle accidents

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Purpose: To investigate the occurrence and types of motor vehicle accident eye trauma in north Israel. Methods: The records between the years 2007–2011 of the Ophthalmology Emergency Room of one medical center were searched. Eye injuries due to motor vehicle accidents were classified according to type, severity of injury and demographic data of patients. Results: Nearly five percents of ER presentations were due to motor vehicle accidents. Most motor vehicle accident-related eye injuries were mild. Conclusion: Efforts should be taken to prevention and to minimize the severity of motor vehicle accident-related eye injuries. Full article

Open AccessArticle Overuse Injuries Associated with Mountain Biking: Is Single-Speed Riding a Predisposing Factor?

by Michael T. Lebec, Kortny Cook and Drew Baumgartel

Sports 2014, 2(1), 1-13; doi:10.3390/sports2010001

Received: 26 November 2013 / Revised: 16 December 2013 / Accepted: 16 December 2013 / Published: 2 January 2014

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Abstract

Though mountain bikers are at significant risk for overuse injury, there is minimal quality research describing this relationship. Single-speed mountain biking, in which participants pedal a bike with only a single gear, may place riders at even greater risk for overuse problems due

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Though mountain bikers are at significant risk for overuse injury, there is minimal quality research describing this relationship. Single-speed mountain biking, in which participants pedal a bike with only a single gear, may place riders at even greater risk for overuse problems due to the disproportionate physical effort associated with this type of riding. The focus of this study was to provide additional perspective on overuse injuries sustained by mountain bikers and to determine if single-speed mountain biking places participants at greater risk for overuse conditions. Four hundred and four (404) mountain bikers were surveyed concerning overuse injuries sustained during the previous year. Findings indicate that 63% of respondents reported an overuse injury affecting at least one area with the most commonly reported areas being the lumbar spine, knees, hand/wrist, and cervical spine. Individuals riding single-speed mountain bikes did not have a higher incidence of overuse injuries than riders of multiple-geared bikes. However, respondents who split time between riding single-speed and multiple-geared bikes were significantly more likely to report an overuse syndrome than those only riding single-speed or multiple-geared bikes (p = 0.0104). This group of riders may be at greater risk for overuse injury due to excessive fatigue and poor biomechanics. Full article

Open AccessArticle Occupational Injuries on Thoroughbred Horse Farms: A Description of Latino and Non-Latino Workers’ Experiences

by Jennifer E. Swanberg, Jessica M. Clouser, Susan C. Westneat, Mary W. Marsh and Deborah B. Reed

Int. J. Environ. Res. Public Health 2013, 10(12), 6500-6516; doi:10.3390/ijerph10126500

Received: 30 August 2013 / Revised: 13 November 2013 / Accepted: 14 November 2013 / Published: 29 November 2013

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Abstract

Animal production is a dangerous industry and increasingly reliant on a Latino workforce. Within animal production, little is known about the risks or the occupational hazards of working on farms involved in various aspects of thoroughbred horse breeding. Extant research suggests that horse

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Animal production is a dangerous industry and increasingly reliant on a Latino workforce. Within animal production, little is known about the risks or the occupational hazards of working on farms involved in various aspects of thoroughbred horse breeding. Extant research suggests that horse workers are at risk of musculoskeletal and respiratory symptoms, kicks, and other injuries. However, limited known research has examined the experiences of the industry’s workers, including immigrant workers, despite their prominence and increased vulnerability. Using data collected from thoroughbred farm representatives via a phone-administered survey, a 2-hour face-to-face semi-structured interview, and farm injury logs, this article identifies and describes types of injuries experienced by workers (N = 284) and their surrounding circumstances. Results indicate that general injuries and musculoskeletal strains, sprains, and tears account for a majority of injuries among workers on thoroughbred farms. Upper limbs and extremities are most frequently injured, while direct contact with the horse accounted for over half of all injuries. No differences in the diagnoses or distribution of injury were found by ethnicity; however, Latinos were more often struck by or trampled by a horse while non-Latinos were more often injured by an insect or plant. Implications and opportunities for future research are discussed. Full article

(This article belongs to the Special Issue Occupational Health)

Open AccessArticle A Comparison between Australian Football League (AFL) Injuries in Australian Indigenous versus Non-indigenous Players

by Jessica Orchard, John Orchard and Hugh Seward

Sports 2013, 1(3), 69-77; doi:10.3390/sports1030069

Received: 31 August 2013 / Revised: 10 September 2013 / Accepted: 11 September 2013 / Published: 16 September 2013

Cited by 1 | Viewed by 1967 | PDF Full-text (318 KB) | HTML Full-text | XML Full-text

Abstract

It has previously been shown that being of aboriginal descent is a risk factor for hamstring injuries in Australian football. The aim of this study was to review the Australian Football League (AFL) injury database to determine whether there were any injuries where

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It has previously been shown that being of aboriginal descent is a risk factor for hamstring injuries in Australian football. The aim of this study was to review the Australian Football League (AFL) injury database to determine whether there were any injuries where indigenous players had different relative risks to non-indigenous players. Analysis was conducted using data from the AFL injury database, which included data from 4,492 players over 21 years (1992–2012), covering 162,683 player-matches at AFL level, 91,098 matches at lower levels and 328,181 weeks (possible matches) of exposure. Compared to non-indigenous players, indigenous players had a significantly higher risk of hamstring injuries (RR 1.52, 95% CI 1.32–1.73) and calf strains (RR 1.30, 95% CI 1.00–1.69). Conversely, indigenous players had a significantly lower risk of lumbar/thoracic spine injuries (RR 0.61, 95% CI 0.41–0.91), groin strains/osteitis pubis (RR 0.75, 95% CI 0.58–0.96) and Achilles tendon injuries (RR 0.32, 95% CI 0.12–0.86). The results for the above injuries were also significant in terms of games missed. There was no difference between overall risk of injury (RR 1.03, 95% CI 0.96–1.10) or missed games (RR 1.00, 95% CI 0.97–1.04). This suggests that indigenous AFL players have the same overall number of injuries and missed games, but a slightly different injury profile. Full article

Open AccessArticle Disseminating Childhood Home Injury Risk Reduction Information in Pakistan: Results from a Community-Based Pilot Study

by Aruna Chandran, Uzma Rahim Khan, Nukhba Zia, Asher Feroze, Sarah Stewart de Ramirez, Cheng-Ming Huang, Junaid A. Razzak and Adnan A. Hyder

Int. J. Environ. Res. Public Health 2013, 10(3), 1113-1124; doi:10.3390/ijerph10031113

Received: 25 January 2013 / Revised: 7 March 2013 / Accepted: 7 March 2013 / Published: 15 March 2013

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Abstract

Background: Most childhood unintentional injuries occur in the home; however, very little home injury prevention information is tailored to developing countries. Utilizing our previously developed information dissemination tools and a hazard assessment checklist tailored to a low-income neighborhood in Pakistan, we pilot

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Background: Most childhood unintentional injuries occur in the home; however, very little home injury prevention information is tailored to developing countries. Utilizing our previously developed information dissemination tools and a hazard assessment checklist tailored to a low-income neighborhood in Pakistan, we pilot tested and compared the effectiveness of two dissemination tools. Methods: Two low-income neighborhoods were mapped, identifying families with a child aged between 12 and 59 months. In June and July 2010, all enrolled households underwent a home hazard assessment at the same time hazard reduction education was being given using an in-home tutorial or a pamphlet. A follow up assessment was conducted 4–5 months later. Results: 503 households were enrolled; 256 received a tutorial and 247 a pamphlet. The two groups differed significantly (p < 0.01) in level of maternal education and relationship of the child to the primary caregiver. However, when controlling for these variables, those receiving an in-home tutorial had a higher odds of hazard reduction than the pamphlet group for uncovered vats of water (OR 2.14, 95% CI: 1.28, 3.58), an open fire within reach of the child (OR 3.55, 95% CI: 1.80, 7.00), and inappropriately labeled cooking fuel containers (OR 1.86, 95% CI: 1.07, 3.25). Conclusions: This pilot project demonstrates the potential utility of using home-visit tutorials to decrease home hazards in a low-income neighborhood in Pakistan. A longer-term randomized study is needed to assess actual effectiveness of the use of allied health workers for home-based injury education and whether this results in decreased home injuries. Full article

(This article belongs to the Special Issue Child Injury Prevention) Printed Edition available

Open AccessArticle Childhood Mortality Due to Unintentional Injuries in Japan, 2000–2009

by Hideaki Sekii, Tadahiro Ohtsu, Takako Shirasawa, Hirotaka Ochiai, Takaya Shimizu and Akatsuki Kokaze

Int. J. Environ. Res. Public Health 2013, 10(2), 528-540; doi:10.3390/ijerph10020528

Received: 19 September 2012 / Revised: 21 January 2013 / Accepted: 23 January 2013 / Published: 30 January 2013

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Abstract

This study examined deaths due to unintentional injuries among children in Japan to identify the age groups and sexes at most risk, and the types of injuries, so that effective forms of targeted intervention can be devised. Among children aged 0–14 years, deaths

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This study examined deaths due to unintentional injuries among children in Japan to identify the age groups and sexes at most risk, and the types of injuries, so that effective forms of targeted intervention can be devised. Among children aged 0–14 years, deaths whose underlying causes had been classified under code V01-X59 of the ICD-10 were defined as deaths of children caused by unintentional injuries. Using data from the Vital Statistics 2000–2009 for analysis, we examined the changes in mortality and trends in terms of sex, age, and cause of death. Mortality decreased by 46.2%, from 933 in 2000 to 502 in 2009. The mortality rate among children aged 1–4 years decreased by almost half. The total number of deaths during this decade was 7,362 (boys: 4,690, girls: 2,672). Among the causes of death, the majority were due to “transport accidents”, followed by “other accidental threats to breathing”, and “accidental drowning and submersion”. The characteristics observed in terms of sex, age, and cause of death—that is, deaths from suffocation among infants aged less than 1 year, drowning deaths among boys, and transport accidents involving pedestrians and cyclists—must be addressed as targets for future intervention. Full article

Open AccessArticle Scale-Up Approach in CATI Surveys for Estimating the Number of Foreign Body Injuries in the Aero-Digestive Tract in Children

by Silvia Snidero, Nicola Soriani, Ileana Baldi, Federica Zobec, Paola Berchialla and Dario Gregori

Int. J. Environ. Res. Public Health 2012, 9(11), 4056-4067; doi:10.3390/ijerph9114056

Received: 3 July 2012 / Revised: 22 October 2012 / Accepted: 8 November 2012 / Published: 12 November 2012

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Abstract

Foreign body injuries are a well-known threat to children due to the high risk of ingestion of small objects and choking. In order to depict the epidemiological framework of such injuries, data are mostly available for hospitalizations and partially for emergency room visits.

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Foreign body injuries are a well-known threat to children due to the high risk of ingestion of small objects and choking. In order to depict the epidemiological framework of such injuries, data are mostly available for hospitalizations and partially for emergency room visits. The hidden part of the phenomenon consisting of minor self-resolved injuries is still unknown. The purpose of this paper is to provide an estimate of the overall burden of such injuries in children in Italy. Our paper proposes the use of the scale up technique to overcome most of the pitfalls of classical techniques in the estimation of the number of children aged 0–14 that suffered a foreign body injury in 2004. Our results, based on a CATI survey on 1,081 women, show that the estimated number of children under 15 years that incurred in a foreign body injury was 15,829 (95% CI: 14,376–17,282), of these 12,844 were treated in hospital or in emergency department (95% CI: 11,535–14,153). The scale-up method in conjunction with a CATI survey provides a reliable estimate of the size of hard-to-count populations as those of injured children at lower costs with respect to classical sampling schemes. Full article

(This article belongs to the Special Issue Child Injury Prevention) Printed Edition available

Open AccessReview Effect of PACAP in Central and Peripheral Nerve Injuries

by Andrea Tamas, Dora Reglodi, Orsolya Farkas, Erzsebet Kovesdi, Jozsef Pal, John T. Povlishock, Attila Schwarcz, Endre Czeiter, Zalan Szanto, Tamas Doczi, Andras Buki and Peter Bukovics

Int. J. Mol. Sci. 2012, 13(7), 8430-8448; doi:10.3390/ijms13078430

Received: 11 May 2012 / Revised: 25 June 2012 / Accepted: 26 June 2012 / Published: 6 July 2012

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Abstract

Pituitary adenylate cyclase activating polypeptide (PACAP) is a bioactive peptide with diverse effects in the nervous system. In addition to its more classic role as a neuromodulator, PACAP functions as a neurotrophic factor. Several neurotrophic factors have been shown to play an important

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Pituitary adenylate cyclase activating polypeptide (PACAP) is a bioactive peptide with diverse effects in the nervous system. In addition to its more classic role as a neuromodulator, PACAP functions as a neurotrophic factor. Several neurotrophic factors have been shown to play an important role in the endogenous response following both cerebral ischemia and traumatic brain injury and to be effective when given exogenously. A number of studies have shown the neuroprotective effect of PACAP in different models of ischemia, neurodegenerative diseases and retinal degeneration. The aim of this review is to summarize the findings on the neuroprotective potential of PACAP in models of different traumatic nerve injuries. Expression of endogenous PACAP and its specific PAC1 receptor is elevated in different parts of the central and peripheral nervous system after traumatic injuries. Some experiments demonstrate the protective effect of exogenous PACAP treatment in different traumatic brain injury models, in facial nerve and optic nerve trauma. The upregulation of endogenous PACAP and its receptors and the protective effect of exogenous PACAP after different central and peripheral nerve injuries show the important function of PACAP in neuronal regeneration indicating that PACAP may also be a promising therapeutic agent in injuries of the nervous system. Full article

(This article belongs to the Special Issue Neuroprotective Strategies 2012)

Open AccessArticle Breakfast and Snacks: Associations with Cognitive Failures, Minor Injuries, Accidents and Stress

by Katherine Chaplin and Andrew P. Smith

Nutrients 2011, 3(5), 515-528; doi:10.3390/nu3050515

Received: 20 March 2011 / Revised: 25 April 2011 / Accepted: 3 May 2011 / Published: 4 May 2011

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Abstract

One strategy for examining effects of nutrients on cognitive function is to initially investigate foods that contain many different nutrients. If effects are demonstrated with these foods then further studies can address the role of specific nutrients. Breakfast foods (e.g., cereals, dairy products

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One strategy for examining effects of nutrients on cognitive function is to initially investigate foods that contain many different nutrients. If effects are demonstrated with these foods then further studies can address the role of specific nutrients. Breakfast foods (e.g., cereals, dairy products and fruit) provide many important nutrients and consumption of breakfast has been shown to be associated with beneficial effects on cognitive function. Isolating effects of specific constituents of breakfast has proved more difficult and it is still unclear what impact breakfast has on real-life performance. The present study provided initial information on associations between breakfast consumption and cognitive failures and accidents. A second aim was to examine associations between consumption of snacks which are often perceived as being unhealthy (chocolate, crisps and biscuits). A sample of over 800 nurses took part in the study. The results showed that frequency of breakfast consumption (varied breakfasts: 62% cereal) was associated with lower stress, fewer cognitive failures, injuries and accidents at work. In contrast, snacking on crisps, chocolate and biscuits was associated with higher stress, more cognitive failures and more injuries outside of work. Further research requires intervention studies to provide a clearer profile of causality and underlying mechanisms. Full article

(This article belongs to the Special Issue Cognitive Benefits of Nutrients)

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