Development of a school connectedness component of an adolescent injury prevention program : lessons for implementation

The school environment plays an important role in shaping adolescent outcomes, and research increasingly demonstrates the need to target the school social context in health promotion programs. This paper describes the research process undertaken to design a school connectedness component of an injury prevention program for early adolescents, Skills for Preventing Injury in Youth (SPIY). The connectedness component takes the form of a professional development workshop for teachers on increasing students’ connectedness to school, and this paper describes the research process used to construct program material. It also describes the methods used to encourage teachers’ implementation of connectedness strategies following program delivery. A multi-stage process of data collection included, (i) surveys with 540 Grade 9 students to examine links between school connectedness and risk-related injury, (ii) a systematic literature review of previously-evaluated school connectedness programs to determine key strategies that encourage implementation fidelity and program effectiveness, and (iii) interviews with 14 high school teachers to understand current use of connectedness strategies and ideas for program design. Findings from each stage are discussed in terms of how results informed the program design. The survey data provided information from which to frame program content, and the results of the systematic review demonstrated effective program strategies. The teacher interview data also provided program content incorporating target participants’ views and aligning with their priorities, which is important to ensure effective implementation of program strategies. A comprehensive design process provides an understanding of methods for, and may encourage, teachers’ future implementation of program strategies.

Study protocol : Screening and treatment of alcohol-related trauma (START): a randomised controlled trial

Background: The incidence of mandibular fractures in the Northern Territory of Australia is very high, especially among Indigenous people. Alcohol intoxication is implicated in the majority of facial injuries, and substance use is therefore an important target for secondary prevention. The current study tests the efficacy of a brief therapy, Motivational Care Planning, in improving wellbeing and substance misuse in youth and adults hospitalised with alcohol-related facial trauma. Methods and design: The study is a randomised controlled trial with 6 months of follow-up, to examine the effectiveness of a brief and culturally adapted intervention in improving outcomes for trauma patients with at-risk drinking admitted to the Royal Darwin Hospital maxillofacial surgery unit. Potential participants are identified using AUDIT-C questionnaire. Eligible participants are randomised to either Motivational Care Planning (MCP) or Treatment as Usual (TAU). The outcome measures will include quantity and frequency of alcohol and other substance use by Timeline Followback. The recruitment target is 154 participants, which with 20% dropout, is hoped to provide 124 people receiving treatment and follow-up. Discussion: This project introduces screening and brief interventions for high-risk drinkers admitted to the hospital with facial trauma. It introduces a practical approach to integrating brief interventions in the hospital setting, and has potential to demonstrate significant benefits for at-risk drinkers with facial trauma.

Analysis of traffic injury severity in a mega city of a developing country

Despite a considerable amount of research on traffic injury severities, relatively little is known about the factors influencing traffic injury severity in developing countries, and in particular in Bangladesh. Road traffic crashes are a common headline in daily newspapers of Bangladesh. It has also recorded one of the highest road fatality rates in the world. This research identifies significant factors contributing to traffic injury severity in Dhaka – a mega city and capital of Bangladesh. Road traffic crash data of 5 years from 2007 to 2011 were collected from the Dhaka Metropolitan Police (DMP), which included about 2714 traffic crashes. The severity level of these crashes was documented in a 4-point ordinal scale: no injury (property damage), minor injury, severe injury, and death. An ordered Probit regression model has been estimated to identify factors contributing to injury severities. Results show that night time influence is associated with a higher level injury severity as is for individuals involved in single vehicle crashes. Crashes on highway sections within the city are found to be more injurious than crashes along the arterial and feeder roads. There is a lower likelihood of injury severity, however, if the road sections are monitored and enforced by the traffic police. The likelihood of injuries is lower on two-way traffic arrangements than one-way, and at four-legged intersections and roundabouts compare to road segments. The findings are compared with those from developed countries and the implications of this research are discussed in terms of policy settings for developing countries.

Injuries leading to hospitalisation in the first year of life : analysis by trimester of age using coded data and textual description

Objective: To describe unintentional injuries to children aged less than one year, using coded and textual information, in three-month age bands to reflect their development over the year. Methods: Data from the Queensland Injury Surveillance Unit was used. The Unit collects demographic, clinical and circumstantial details about injured persons presenting to selected emergency departments across the State. Only injuries coded as unintentional in children admitted to hospital were included for this analysis. Results: After editing, 1,082 children remained for analysis, 24 with transport-related injuries. Falls were the most common injury, but becoming proportionately less over the year, whereas burns and scalds and foreign body injuries increased. The proportion of injuries due to contact with persons or objects varied little, but poisonings were relatively more common in the first and fourth three-month periods. Descriptions indicated that family members were somehow causally involved in 16% of injuries. Our findings are in qualitative agreement with comparable previous studies. Conclusion: The pattern of injuries varies over the first year of life and is clearly linked to the child's increasing mobility. Implications: Injury patterns in the first year of life should be reported over shorter intervals. Preventive measures for young children need to be designed with their rapidly changing developmental stage in mind, using a variety of strategies, one of which could be opportunistic developmentally specific education of parents. Injuries in young children are of abiding concern given their immediate health and emotional effects, and potential for long-term adverse sequelae. In Australia, in the financial year 2006/07, 2,869 children less than 12 months of age were admitted to hospital for an unintentional injury, a rate of 10.6 per 1,000, representing a considerable economic and social burden. Given that many of these injuries are preventable, this is particularly concerning. Most epidemiologic studies analyse data in five-year age bands, so children less than five years of age are examined as a group. This study includes only those children younger than one year of age to identify injury detail lost in analyses of the larger group, as we hypothesised that the injury pattern varied with the developmental stage of the child. The authors of several North American studies have commented that in dealing with injuries in pre-school children, broad age groupings are inadequate to do justice to the rapid developmental changes in infancy and early childhood, and have in consequence analysed injuries in shorter intervals. To our knowledge, no similar analysis of Australian infant injuries has been published to date. This paper describes injury in children less than 12 months of age using data from the Queensland Injury Surveillance Unit (QISU).

Urinary biomolecular indicators of exercise-induced over exertion injury

Poor health and injury represent major obstacles to the future economic security of Australia. The national economic cost of work-related injury is estimated at $57.5 billion p/a. Since exposure to high physical demands is a major risk factor for musculoskeletal injury, monitoring and managing such physical activity levels in workers is a potentially important injury prevention strategy. Current injury monitoring practices are inadequate for the provision of clinically valuable information about the tissue specific responses to physical exertion. Injury of various soft tissue structures can manifest over time through accumulation of micro-trauma. Such micro-trauma has a propensity to increase the risk of acute injuries to soft-tissue structures such as muscle or tendon. As such, the capacity to monitor biomarkers that result from the disruption of these tissues offers a means of assisting the pre-emptive management of subclinical injury prior to acute failure or for evaluation of recovery processes. Here we have adopted an in-vivo exercise induced muscle damage model allowing the application of laboratory controlled conditions to assist in uncovering biochemical indicators associated with soft-tissue trauma and recovery. Importantly, urine was utilised as the diagnostic medium since it is non-invasive to collect, more acceptable to workers and less costly to employers. Moreover, it is our hypothesis that exercise induced tissue degradation products enter the circulation and are subsequently filtered by the kidney and pass through to the urine. To test this hypothesis a range of metabolomic and proteomic discovery-phase techniques were used, along with targeted approaches. Several small molecules relating to tissue damage were identified along with a series of skeletal muscle-specific protein fragments resulting from exercise induced soft-tissue damage. Each of the potential biomolecular markers appeared to be temporally present within urine. Moreover, the regulation of abundance seemed to be associated with functional recovery following the injury. This discovery may have important clinical applications for monitoring of a variety of inflammatory myopathies as well as novel applications in monitoring of the musculoskeletal health status of workers, professional athletes and/or military personnel to reduce the onset of potentially debilitating musculoskeletal injuries within these professions.

How accurate is the identification of serious traffic injuries by Police? The concordance between Police and hospital reported traffic injuries

Police reported crash data are the primary source of crash information in most jurisdictions. However, the definition of serious injury within police-reported data is not consistent across jurisdictions and may not be accurate. With the Australian National Road Safety Strategy targeting the reduction of serious injuries, there is a greater need to assess the accuracy of the methods used to identify these injuries. A possible source of more accurate information relating to injury severity is hospital data. While other studies have compared police and hospital data to highlight the under-reporting in police-reported data, little attention has been given to the accuracy of the methods used by police to identify serious injuries. The current study aimed to assess how accurate the identification of serious injuries is in police-reported crash data, by comparing the profiles of transport-related injuries in the Queensland Road Crash Database with an aligned sample of data from the Queensland Hospital Admitted Patients Data Collection. Results showed that, while a similar number of traffic injuries were recorded in both data sets, the profile of these injuries was different based on gender, age, location, and road user. The results suggest that the ‘hospitalisation’ severity category used by police may not reflect true hospitalisations in all cases. Further, it highlights the wide variety of severity levels within hospitalised cases that are not captured by the current police-reported definitions. While a data linkage study is required to confirm these results, they highlight that a reliance on police-reported serious traffic injury data alone could result in inaccurate estimates of the impact and cost of crashes and lead to a misallocation of valuable resources.

A spatial-indexing model for measuring neighbourhood-level land-use and transport integration

Significant attention has been given in urban policy literature to the integration of land-use and transport planning and policies—with a view to curbing sprawling urban form and diminishing externalities associated with car-dependent travel patterns. By taking land-use and transport interaction into account, this debate mainly focuses on how a successful integration can contribute to societal well-being, providing efficient and balanced economic growth while accomplishing the goal of developing sustainable urban environments and communities. The integration is also a focal theme of contemporary urban development models, such as smart growth, liveable neighbourhoods, and new urbanism. Even though available planning policy options for ameliorating urban form and transport-related externalities have matured—owing to growing research and practice worldwide—there remains a lack of suitable evaluation models to reflect on the current status of urban form and travel problems or on the success of implemented integration policies. In this study we explore the applicability of indicator-based spatial indexing to assess land-use and transport integration at the neighbourhood level. For this, a spatial index is developed by a number of indicators compiled from international studies and trialled in Gold Coast, Queensland, Australia. The results of this modelling study reveal that it is possible to propose an effective metric to determine the success level of city plans considering their sustainability performance via composite indicator methodology. The model proved useful in demarcating areas where planning intervention is applicable, and in identifying the most suitable locations for future urban development and plan amendments. Lastly, we integrate variance-based sensitivity analysis with the spatial indexing method, and discuss the applicability of the model in other urban contexts.

Addressing alcohol related harms within maxillofacial trauma practice

Background A brief intervention, conducted in the acute setting care setting after an alcohol-related injury, has been reported to be highly beneficial in reducing the risk of re-injury and in reducing subsequent level of alcohol consumption. This project aimed to understand Australasian Oral and Maxillofacial Surgeons' attitudes, knowledge and skills in terms of alcohol screening and brief intervention within acute settings for patients admitted with facial trauma. Materials and Methods A web-based survey was made available to all members (n=200-250) of the Australian and New Zealand Association of Oral and Maxillofacial Surgeons (ANZAOMS), promoted through a number of email bulletins sent by the Association to all members. Implied consent is assumed for participants who complete the online survey. The survey explored their current level of involvement in treating patients with alcohol-relatd facial trauma, as well as their knowledge of and attitudes towards alcohol screening and brief intervention. The survey also explored their willingness for further training and involvement in implementing a SBI program. Parts of the survey were based on a hypothetical case with facial injury and drinking history which was presented to the participants and the participants were asked to give their response to this scenario. Results A total of 58 surgeons completed the on-line survey. 91% of surgeons surveyed were males and 88% were consultant surgeons. 71% would take alcohol history; 29% would deliver a brief alcohol intervention and 14% would refer the patients to an alcohol treatment service or clinician. 40% agreed to have adequate training in managing patients with alcohol-related injuries, while 17% and 19% felt they had adequate time and resources. 76% of surgeons reported the need for more information on where to refer patients for appropriate alcohol treatment. Conclusion The study findings confirm the challenges and barriers to implementing brief alcohol intervention in current practice. There are service gaps that exist, as well as opportunities for training.

Developing and evaluating approaches for utilising injury data to support product safety initiatives

With increasing concern about consumer product-related injuries in Australia, product safety regulators need evidence-based research to understand risks and patterns to inform their decision making. This study analysed paediatric injury data to identify and quantify product-related injuries in children to inform product safety prioritisation. This study provides information on novel techniques for interrogating health data to identify trends and patterns in product-related injuries to inform strategic directions in this growing area of concern.

Where to after Drink Rite: An evaluation of opportunities for police and community promotion of an anti-drink driving message in the licensed venue setting. Report to the National Drug Strategy Law Enforcement Funding Committee

Estimating the prevalence of drink driving is a difficult task. Self‐reported drink driving indicates that drink driving is far more common than official statistics suggest. In order to promote a responsible attitude towards alcohol consumption and drink driving within the Queensland community, the Queensland Police Service, Queensland Health and Queensland Transport developed the ‘Drink Rite’ program (Queensland Police Service information sheet, 2009). However, the feasibility of the program is now in doubt as the National Health and Medical Research Council’s guidelines for alcohol consumption changed in 2009 to state “For healthy men and women, drinking no more than four standard drinks on a single occasion reduces the risk of alcohol‐related injury arising from that occasion” (NHMRC Publication, 2009, p. 51). As such, adhering to the NHMRC guidelines places restrictions on how the existing Drink Rite program can be operated (i.e. by reducing the number of standard drinks provided to participants from eight to four). It is arguable that a reduction in the number of alcoholic drinks provided to participants in the program will result in a large reduction in observed BAC readings. This, in turn, will lead to a potential loss of message content when discussing the variation in the effects of alcohol.

Comparative efficacy of MS-222 and benzocaine as anaesthetics under simulated transport conditions of a tropical ornamental fish Puntius filamentosus(Valenciennes)

There is a growing commercial interest in the ¢sh, Puntius ¢lamentosus, in the ornamental ¢sh trade in India and elsewhere.The trade is, however, hampered by severe mortalities during transport of the ¢sh owing to insu⁄cient data available on the use of anaesthetics. To resolve this problem, we evaluated the e⁄cacy of two anaesthetics, MS-222 and benzocaine, in sedating P. ¢lamentosus in simulated transportation experiments and used stress response parameters such as cortisol and blood glucose levels to perform assessments. We observed that MS-222 at 40 mg L 1 and benzocaine at 20mg L 1 were su⁄- cient to induce sedation for 48 h. Above these concentrations, both the anaesthetics adversely a¡ected the ¢sh and resulted inmortalities. Both anaesthetics signi¢cantly lowered the blood cortisol and glucose levels compared with the unsedated controls. Importantly, the anaesthetics treatment signi¢cantly lowered the post-transport mortality in the ¢sh. The results of the study show that MS-222 and benzocaine could be used as sedatives to alleviate transport- related stress in P. ¢lamentosus to improve their post-transport survival and hence reduce economic loss.

EfeO-cupredoxins: major new members of the cupredoxin superfamily with roles in bacterial iron transport

The EfeUOB system of Escherichia coli is a tripartite, low pH, ferrous iron transporter. It resembles the high-affinity iron transporter (Ftr1p-Fet3p) of yeast in that EfeU is homologous to Ftr1p, an integral-membrane iron-permease. However, EfeUOB lacks an equivalent of the Fet3p component—the multicopper oxidase with three cupredoxin-like domains. EfeO and EfeB are periplasmic but their precise roles are unclear. EfeO consists primarily of a C-terminal peptidase-M75 domain with a conserved ‘HxxE’ motif potentially involved in metal binding. The smaller N-terminal domain (EfeO-N) is predicted to be cupredoxin (Cup) like, suggesting a previously unrecognised similarity between EfeO and Fet3p. Our structural modelling of the E. coli EfeO Cup domain identifies two potential metal-binding sites. Site I is predicted to bind Cu2+ using three conserved residues (C41 and 103, and E66) and M101. Of these, only one (C103) is conserved in classical cupredoxins where it also acts as a Cu ligand. Site II most probably binds Fe3+ and consists of four well conserved surface Glu residues. Phylogenetic analysis indicates that the EfeO-Cup domains form a novel Cup family, designated the ‘EfeO-Cup’ family. Structural modelling of two other representative EfeO-Cup domains indicates that different subfamilies employ distinct ligand sets at their proposed metal-binding sites. The ~100 efeO homologues in the bacterial sequence databases are all associated with various iron-transport related genes indicating a common role for EfeO-Cup proteins in iron transport, supporting a new copper-iron connection in biology.

Transport impacts on atmosphere and climate: metrics

The transport sector emits a wide variety of gases and aerosols, with distinctly different characteristics which influence climate directly and indirectly via chemical and physical processes. Tools that allow these emissions to be placed on some kind of common scale in terms of their impact on climate have a number of possible uses such as: in agreements and emission trading schemes; when considering potential trade-offs between changes in emissions resulting from technological or operational developments; and/or for comparing the impact of different environmental impacts of transport activities. Many of the non-CO2 emissions from the transport sector are short-lived substances, not currently covered by the Kyoto Protocol. There are formidable difficulties in developing metrics and these are particularly acute for such short-lived species. One difficulty concerns the choice of an appropriate structure for the metric (which may depend on, for example, the design of any climate policy it is intended to serve) and the associated value judgements on the appropriate time periods to consider; these choices affect the perception of the relative importance of short- and long-lived species. A second difficulty is the quantification of input parameters (due to underlying uncertainty in atmospheric processes). In addition, for some transport-related emissions, the values of metrics (unlike the gases included in the Kyoto Protocol) depend on where and when the emissions are introduced into the atmosphere – both the regional distribution and, for aircraft, the distribution as a function of altitude, are important. In this assessment of such metrics, we present Global Warming Potentials (GWPs) as these have traditionally been used in the implementation of climate policy. We also present Global Temperature Change Potentials (GTPs) as an alternative metric, as this, or a similar metric may be more appropriate for use in some circumstances. We use radiative forcings and lifetimes from the literature to derive GWPs and GTPs for the main transport-related emissions, and discuss the uncertainties in these estimates. We find large variations in metric (GWP and GTP) values for NOx, mainly due to the dependence on location of emissions but also because of inter-model differences and differences in experimental design. For aerosols we give only global-mean values due to an inconsistent picture amongst available studies regarding regional dependence. The uncertainty in the presented metric values reflects the current state of understanding; the ranking of the various components with respect to our confidence in the given metric values is also given. While the focus is mostly on metrics for comparing the climate impact of emissions, many of the issues are equally relevant for stratospheric ozone depletion metrics, which are also discussed.

Business parks and town centre workplaces in England: a comparative analysis of commuting-related energy consumption

To fully appreciate the environmental impact of a workplace the transport-related carbon dioxide (CO2) emissions resulting from its location should be considered in addition to the emissions that result from the occupation of the building itself. Since the first one was built in the early 1980s, business parks have become a significant workplace location for service-sector workers; a sector of the economy that grew rapidly at that time as the UK manufacturing output declined and the employment base shifted to retail services and de-regulated financial services. This paper examines the transport-related CO2 emissions associated with these workplace locations in comparison to town and city centre locations. Using 2001 Census Special Workplace Statistics which record people’s residence, usual workplace and mode of transport between them, distance travelled and mode of travel were calculated for a sample of city centre and out-of-town office locations. The results reveal the extent of the difference between transport-related CO2 emitted by commuters to out-of-town and city centre locations. The implications that these findings have for monitoring the environmental performance of workplaces are discussed.

Caracterização da cinética de captação de glutamato por cromatografia líquida de alta eficiência em tecido retiniano

O presente estudo descreve um método eficiente e simples utilizando cromatografia líquida de alta eficiência (CLAE) acoplada a detector de fluorescência para determinação dos parâmetros cinéticos da captação de glutamato (glu) no sistema nervoso central (SNC). O tecido retiniano embrionário de ave com sete dias de desenvolvimento foi incubado com concentrações conhecidas de glu (50-500 μM) por dez minutos. Os níveis do aminoácido derivado a partir de ortoftaldeído (OPA) no meio de incubação foram mensurados. Após avaliar a diferença entre a concentração de glu inicial e a final no meio, foi determinada a saturação do mecanismo de captação (Km = 8,2 e Vmax = 9,8 nmol/mg proteína/minuto). Estas determinações foram dependentes e independentes de sódio e temperatura, indicando que o mecanismo que regula a diminuição dos níveis de glu no SNC, é a captação via transportadores de alta afinidade. Além disso, o cloreto de zinco (ZnCl) (um inibidor do transportador glu/aspartato) foi utilizado em diversas concentrações e evocou diminuição da captação de glu. Com isto, destaca-se a elevada aplicabilidade desta metodologia. Além deste trabalho caracterizar metodologia alternativa para avaliar captação de glu no SNC usando CLAE, também pode ser importante ferramenta para estudos relacionados à caracterização do transporte do neurotransmissor durante injúrias no SNC.