Objective: Currently only 5 out of the 50 states in the United States have laws restricting the age of passengers permitted to ride on a motorcycle. This study sought to characterize the visits by patients under the age of 16 to U.S. emergency departments (EDs) for injuries sustained as a passenger on a motorcycle.
Methods: In this retrospective cohort study, data were obtained from the Nationwide Emergency Department Sample (NEDS) for the years 2006 to 2011. Pediatric patients who were passengers on a motorcycle that was involved in a crash were identified using International Classification of Diseases, Ninth Revision (ICD-9) External Cause of Injury codes. We also examined gender, age, disposition, regional differences, common injuries, and charges.
Results: Between 2006 and 2011 there were an estimated 9,689 visits to U.S. EDs by patients under the age of 16 who were passengers on a motorcycle involved in a crash. The overall average patient age was 9.4 years, and they were predominately male (54.5%). The majority (85%) of these patients were treated and released. The average charges for discharged patients were $2,116.50 and amounted to roughly $17,500,000 during the 6 years. The average cost for admission was $51,446 per patient and totaled over $54 million. The most common primary injuries included superficial contusions; sprains and strains; upper limb fractures; open wounds of head, neck, and trunk; and intracranial injuries.
Conclusion: Although there were only about 9,700 visits to U.S. EDs for motorcycle crashes involving passengers less than 16 years old for 2006 to 2011, the total cost of visits that resulted in either ED discharge or hospital admission amounted to over $71 million. 相似文献
Achievement of at least “good ecological status” in all waterbodies under the EU Water Framework Directive by 2015 will in some cases be a challenge. The twin challenge is to manage expectations of policy makers for such waterbodies as to a realistic length of time required for improvement in water quality. Hence, understanding the source, transformation processes and residence time of nitrate in a hydrological system is an essential part of meeting such challenges. On a dairy farm with 24 shallow groundwater wells, the dual isotopic composition of nitrate (δ15N and δ18O) was used to clarify nitrate sources, to assess spatial and temporal variability in nitrate concentrations and to determine if and where denitrification was occurring. Vertical travel time was estimated to correlate nitrate concentrations with management practices. Organically derived nitrogen was the predominant source contributing to groundwater nitrate concentrations. Denitrification was identified as prevalent within specific regions of the study site. The distinct low temporal variability in the isotopic data suggests constancy among nitrate sources and processes over time across the study site. Vertical travel times of up to 3 years were estimated on site indicating the influence of recent management practices on nitrate concentrations. Very slow horizontal migration of groundwater (decades) indicates a legacy of older management practices. Stable isotope techniques, together with an understanding of time lag, provide an extra mechanism to test the efficacy of monitoring and mitigation programmes. 相似文献
Objective: Drink-driving represents a critical issue on international organizations’ agendas as one of the key behavioral risk factors in road traffic safety, alongside speed and nonuse of motorcycle helmets, seat belts, and child restraints. Changing road user behaviors regarding these 5 factors is a critical component in reducing road traffic injuries and casualties. The objective of this study is the identification of drivers who are more likely to contribute to crashes in the UK while impaired by alcohol to design targeted drink drive compliance campaigns.
Method: To profile drivers with the factor “impaired by alcohol” assigned in collisions, an extensive data set is used, including all reported injury collisions between 2011 and 2015 in the UK (police records), merged with the Experian Mosaic Database. A multilevel mixed-effects logistic regression is conducted, utilizing the hierarchical nature of the data (drivers within Mosaic types).
Results: Using multilevel mixed-effects logistic regression analysis, the finding is that some driver profiles are more likely to contribute to crashes and are assigned the contributory factor “impaired by alcohol.” Drink-related crashes are more common in some circumstances or for some crash-involved driver groups than others. For instance, alcohol-related crashes are more likely to occur on single carriageways and among males and 25- to 35-year-olds. Drink-drive-related crashes are found to be strongly associated with dark lighting conditions and, more specifically, with late night hours (the interval between 3:00 a.m. and 4:00 a.m. accounts for a third of the drink-drive-related collisions). Using the Experian Mosaic Database which divides the UK population into 66 types based on demographic, lifestyle, and behavior characteristics, the finding is that, among crash-involved drivers, some Mosaic types are significantly more likely (e.g., pocket pensions, dependent greys, streetwise singles) and others are significantly less likely (e.g., crowded kaleidoscope, cultural comfort, penthouse chic) to contribute to a drink-related crash.
Conclusions: The outcome is a more nuanced understanding of drivers contributing to drink-related crashes in the UK. The study concludes by discussing the implications for governments and other interested bodies for better targeting and delivery of public education campaigns and interventions. 相似文献
This study explores the dilemma of whether to rebuild or relocate from the areas devastated by Hurricane Sandy in 2012. Since disasters represent the discernible manifestation of other complex coastal hazards, they offer a window of opportunity to engage residents in the dialogue on relocation as sometimes the most effective risk reduction strategy. The following research evaluates attitudes towards relocation and willingness to consider buyout among 46 surveyed households located in highly‐affected communities five months after Sandy. It also gauges perceptions of coastal risks and recovery concerns as drivers of relocation, the level of support for different adaptation strategies, and preferences related to the relocation process itself on how and where to relocate and with what type of assistance. Responses indicate that, even though residents prefer structural solutions to address coastal hazards, they are not fully opposed to the possibility of relocation mostly for personal health and safety reasons. 相似文献
This paper discusses the extent to which charity-led initiatives can contribute to capacity building for food justice in England. The paper draws on evaluations of two projects run by the charity Garden Organic: the Master Gardener Programme, operating a network of volunteers who mentor households, schools and community groups to support local food growing, and the Sowing New Seeds programme, which engages “Seed Stewards” to work with communities to encourage the growing and cooking of “exotic” crops. Based on qualitative data about peoples’ motivations for participation and the benefits that are experienced, we interpret these projects as examples of capacity building for food justice. We suggest that whilst currently depoliticised, the “quiet” process of reskilling and awareness raising that occurs through shared gardening projects could have transformative potential for people’s relationship with food. Finally, we use our findings to raise critical questions and propose future research about food justice concepts and practices. 相似文献
Denitrification is a critical biogeochemical process that results in the conversion of nitrate to volatile products, and thus is a major route of nitrogen loss from terrestrial environments. Riparian buffers are an important management tool that is widely utilized to protect water from non-point source pollution. However, riparian buffers vary in their nitrate removal effectiveness, and thus there is a need for mechanistic studies to explore nitrate dynamics in buffer soils. The objectives of this study were to examine the influence of specific types of soluble organic matter on nitrate loss and nitrous oxide production rates, and to elucidate the relationships between these rates and the abundances of functional genes in a riparian buffer soil. Continuous-flow soil column experiments were performed to investigate the effect of three types of soluble organic matter (citric acid, alginic acid, and Suwannee River dissolved organic carbon) on rates of nitrate loss and nitrous oxide production. We found that nitrate loss rates increased as citric acid concentrations increased; however, rates of nitrate loss were weakly affected or not affected by the addition of the other types of organic matter. In all experiments, rates of nitrous oxide production mirrored nitrate loss rates. In addition, quantitative polymerase chain reaction (qPCR) was utilized to quantify the number of genes known to encode enzymes that catalyze nitrite reduction (i.e., nirS and nirK) in soil that was collected at the conclusion of column experiments. Nitrate loss and nitrous oxide production rates trended with copy numbers of both nir and 16s rDNA genes. The results suggest that low-molecular mass organic species are more effective at promoting nitrogen transformations than large biopolymers or humic substances, and also help to link genetic potential to chemical reactivity. 相似文献
A key challenge in ecology is to find ways to obtain complete and accurate information about the diets of animals. To respond to this challenge in seabirds, traditional methods (usually stomach content analysis or observations of prey at nests) have been supplemented with indirect methods or molecular trophic markers. These techniques have the potential to extend the period of investigation outside the few short months of breeding and avoid biases. Here, we use an analysis of fatty acids (FAs) and fatty alcohols (FALs) from blood, adipose tissue and stomach oil to investigate how the diets of male and female common guillemots (Uria aalge), black-legged kittiwakes (Rissa tridactyla) and northern fulmars (Fulmarus glacialis) differed through the sampling period (prelaying and breeding season) and by sex. Diets of both sexes of all three species generally varied across the season, but sex differences were apparent only in fulmars during prelaying. Our study shows that FA/FAL analysis can provide significant insights into diets of seabirds, in particular periods of the annual cycle which are not readily studied using traditional methods. 相似文献