Environmental evaluation for workplace violence in healthcare and social services

PROBLEM: Federal policy recommends environmental strategies as part of a comprehensive workplace violence program in healthcare and social services. The purpose of this project was to contribute specific, evidence-based guidance to the healthcare and social services employer communities regarding the use of environmental design to prevent violence. METHOD: A retrospective record review was conducted of environmental evaluations that were performed by an architect in two Participatory Action Research (PAR) projects for workplace violence prevention in 2000 and, in the second project in 2005. Ten facility environmental evaluation reports along with staff focus group reports from these facilities were analyzed to categorize environmental risk factors for Type II workplace violence. RESULTS: Findings were grouped according to their impact on access control, the ability to observe patients (natural surveillance), patient and worker safety (territoriality), and activity support. DISCUSSION: The environmental assessment findings reveal design and security issues that, if corrected, would improve safety and security of staff, patients, and visitors and reduce fear and unpredictability. IMPACT ON INDUSTRY: Healthcare and social assistance employers can improve the effectiveness of violence prevention efforts by including an environmental assessment with complementary hazard controls.     

Using data linkage to assess the impact of motorized recreational vehicle-related injuries in Ohio

Problem

Motorized recreational vehicle (MRV)-related injuries can result in severe medical and financial consequences. The objective of this study was to describe the epidemiology, and clinical and financial impact of MRV-related injuries in Ohio.

Method

Probabilistically linked statewide Emergency Medical Services (EMS) and hospital (inpatient and emergency department) data for 2003 and 2004 were examined. Record pairs with a MRV-related E-code (E821-E823, E825) were included in this study.

Results

There were 2,893 patients with MRV-related injuries, who had linked EMS and hospital records, resulting in more than $15 million in hospital charges and 1,921 inpatient days of hospitalization. The male-to-female ratio was nearly 4:1, and 19% were younger than 16. Almost 82% of cases were not wearing a helmet; there was a trend of decreasing helmet use with increasing age. Mean (SE) inpatient hospital charges and length of stay (LOS) were $22,218 ($1,290) and 3.8 (0.2) days, respectively. The mean (SE) Injury Severity Score (ISS) for inpatients was 9.2 (0.4). Individuals injured on a street/highway were 3.20 times more likely to sustain an ISS ≥ 16 (95% CI: 1.03, 9.88; p = 0.044) and 3.05 times more likely to sustain a traumatic brain injury (TBI) (95% CI: 1.17, 7.94; p = 0.024) than those who were injured at a place designated for sport or recreation. Children aged 12 to 15 and young adults aged 16 to 25 were 2.47 and 2.14 times more likely, respectively, to sustain a TBI than adults aged 36 or older (aged 12 to 15: 95% CI: 1.13, 5.38; p = 0.024; aged 16 to 25: 95% CI: 1.26, 3.64; p = 0.005). Higher ISS was associated with both higher total charges (p < 0.001) and longer LOS (p < 0.001).

Discussion

This study demonstrates that MRV-related injuries are an important public health problem in Ohio, with a substantial clinical and financial impact.

Impact on Industry

Enactment and enforcement of statewide MRV safety legislation and training of MRV users offer valuable opportunities to prevent these costly injuries.     

Whose lawn is it anyway? Redefining problems and the implementation of municipal stormwater policies

Research of problem definitions typically centres on agenda setting and formulation with less attention given to implementation. In recognition of this gap, this analysis examines the relationship between issue definition, issue redefinition and policy implementation by reviewing two municipal stormwater plans. The results suggest that in larger issue contexts replete with ambiguity and uncertainty, problem definitions are often “tweaked” and adapted during the implementation process. In short, street-level bureaucrats craft “genetically related” but idiosyncratic problem definitions – that fit their own policy-making context. In the case of stormwater, “solutions”; are best described as dynamic policies built upon the values associated with technical expertise, public participation and environmental sustainability.     

Using GIS to Delineate Headwater Stream Origins in the Appalachian Coalfields of Kentucky

Headwater streams have a significant nexus or physical, chemical, and/or biological connection to downstream reaches. Generally, defined as 1st‐3rd order with ephemeral, intermittent, or perennial flow regimes, these streams account for a substantial portion of the total stream network particularly in mountainous terrain. Due to their often remote locations, small size, and large numbers, conducting field inventories of headwater streams is challenging. A means of estimating headwater stream location and extent according to flow regime type using publicly available spatial data is needed to simplify this complex process. Using field‐collected headwater point of origin data from three control watersheds, streams were characterized according to a set of spatial parameters related to topography, geology, and soils. These parameters were (1) compared to field‐collected point of origin data listed in three nearby Jurisdictional Determinations, (2) used to develop a geographic information system (GIS)‐based stream network for identifying ephemeral, intermittent, and perennial streams, and (3) applied to a larger watershed and compared to values obtained using the high‐resolution National Hydrography Dataset (NHD). The parameters drainage area and local valley slope were the most reliable predictors of flow regime type. Results showed the high‐resolution NHD identified no ephemeral streams and 9 and 65% fewer intermittent and perennial streams, respectively, than the GIS model.     

Social media and disasters: a functional framework for social media use in disaster planning,response, and research

A comprehensive review of online, official, and scientific literature was carried out in 2012–13 to develop a framework of disaster social media. This framework can be used to facilitate the creation of disaster social media tools, the formulation of disaster social media implementation processes, and the scientific study of disaster social media effects. Disaster social media users in the framework include communities, government, individuals, organisations, and media outlets. Fifteen distinct disaster social media uses were identified, ranging from preparing and receiving disaster preparedness information and warnings and signalling and detecting disasters prior to an event to (re)connecting community members following a disaster. The framework illustrates that a variety of entities may utilise and produce disaster social media content. Consequently, disaster social media use can be conceptualised as occurring at a number of levels, even within the same disaster. Suggestions are provided on how the proposed framework can inform future disaster social media development and research.