Emergency department visits by pediatric patients sustained as a passenger on a motorcycle

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.     

Variation in perception of environmental change in nine Solomon Islands communities: implications for securing fairness in community-based adaptation

Community-based approaches are pursued in recognition of the need for place-based responses to environmental change that integrate local understandings of risk and vulnerability. Yet the potential for fair adaptation is intimately linked to how variations in perceptions of environmental change and risk are treated. There is, however, little empirical evidence of the extent and nature of variations in risk perception in and between multiple community settings. Here, we rely on data from 231 semi-structured interviews conducted in nine communities in Western Province, Solomon Islands, to statistically model different perceptions of risk and change within and between communities. Overall, people were found to be less likely to perceive environmental changes in the marine environment than they were for terrestrial systems. The distance to the nearest market town (which may be a proxy for exposure to commercial logging and degree of involvement with the market economy), and gender had the greatest overall statistical effects on perceptions of risk. Yet, we also find that significant environmental change is underreported in communities, while variations in perception are not always easily related to commonly assumed fault lines of vulnerability. The findings suggest that there is an urgent need for methods that engage with the drivers of perceptions as part of community-based approaches. In particular, it is important to explicitly account for place, complexity and diversity of environmental risk perceptions, and we reinforce calls to engage seriously with underlying questions of power, culture, identity and practice that influence adaptive capacity and risk perception.

     

How and why is Aquatic Quality Changing at Nahanni National Park Reserve, nwt, Canada?

Nahanni National Park Reserve is located at southwestern NWT-Yukon border. One of the first UNESCO World Heritage sites, Nahanni lies within Taiga Cordillera and Taiga Shield Ecozones. Base and precious metal mining occurred upstream of Nahanni prior to park establishment. Nahanni waters, sediments, fish, and caribou have naturally elevated metals levels. Baseline water, sediment and fish tissue quality data were collected and analyzed throughout Nahanni during 1988–91 and 1992–97. These two programs characterized how aquatic quality variables are naturally varying in space and time, affected by geology, stream flow, seasonality, and extreme meteorological and geological events. Possible anthropogenic causes of aquatic quality change were examined. Measured values were compared to existing Guidelines and site-specific objectives were established.     

Can health feasibly be considered as part of the planning process in Scotland?

The planning system is significant because of its capacity to determine the quality of the built environment as well as the health, well-being and quality of life of the individuals and communities therein. Development planning is especially important because of the long-term impact of the decisions. This paper was developed in response to increasing recognition amongst HIA practitioners in Scotland of the importance of planning for health. It focuses on the relationship between the planning system in Scotland, specifically the Development Planning element of it, and population health and considers how the health impact assessment (HIA) approach can facilitate and support joint working with planners. In particular, consideration is given to the potential impact of the introduction of Strategic Environmental Assessment (SEA) on the linkages between health, HIA and planning.     

Organochlorine and mercury residues in Swainson's and ferruginous hawk eggs collected in North and South Dakota, 1974–79

Residues of organochlorine pesticides, polychlorinated biphenyls (PCBs), and mercury were measured in eggs of Swainson's hawks (Buteo swainsoni) and ferruginous hawks (B. regalis) collected in North and South Dakota during 1974–79. DDE was the most common compound detected in the eggs, but residues were below levels known to have adverse effects on reproduction. Other organochlorine compounds and mercury were found at low levels. Eggs of ferruginous hawks tended to contain more compounds with higher residues than eggs of Swainson's hawks.     

Vitamins,folic acid and neural tube defects: Comments on investigations in the United States

No clear answer concerning whether multivitamin/folate supplementation prevents neural tube defects (NTDs) is provided by three studies in the United States. All these studies are occurrence in nature, no recurrence studies having been conducted. The Atlanta Birth Defects Study is subject to pronounced memory and recall biases, the length between event and interview being as long as 16 years. In a second study (Boston University), objections can be raised to certain aspects of the experimental design, and the claim that 22 per cent of women started vitamins sufficiently early after pregnancy diagnosis to influence NTD formation is suspicious. Our NICHD case control study of 541 women in California and Illinois revealed no evidence for multivitamins or folic acid preventing NTDs. U.S. public policy-makers face difficulties in applying results of recurrence or occurrence studies in high-risk areas to low-risk areas in the U.S.     

Gas chromatographic separation and determination of chloroanthracene isomers on fly ash

An efficient, reproducible and rapid fused silica capillary column gas chromatographic method, in splitless mode, for analysing of the three chloroanthracene isomers is described. The method affords efficient separation and good linearity for each isomer in the range of 0.2 -200 μg/ml. The method can also be used in separation and determination of another thirty three aromatic and their halosubstituted compounds. This paper also presents the applications of the method in analysing of complex products mixture from reaction of the selected aromatic compounds with hydrogen chloride on fly ash surface from municipal incinerator.     

Transition to self‐directed work teams: implications of transition time and self‐monitoring for managers' use of influence tactics

In the face of heightened competitive pressures, elevated quality expectations, and calls for worker empowerment, more and more organizations have turned to self‐directed work teams (SDWTs). A review of the literature devoted to SDWTs suggests that managers often struggle with the transition to SDWTs because of the required shift in control to SDWT members. To promote the development of work teams, managers must modify their use of influence tactics in direct response to the control shift. In this study, we explore changes in managers' usage of influence tactics during the transition to SDWTs within a large aluminum manufacturing plant. Analyses of longitudinal data show that despite the new team environment, managers' use of influence tactics was focused at the individual level. We also found that transition time accounts for variance in managers' choices of influence tactics. Finally, an exploratory analysis suggests that high as opposed to low self‐monitoring managers may be more prone to increase their usage of soft influence tactics and decrease their usage of hard influence tactics over the course of the transition; the influence behavior of low self‐monitoring managers remained unchanged. Implications for future research are discussed. Copyright © 2004 John Wiley & Sons, Ltd.     

ENHANCING FECAL COLIFORM TOTAL MAXIMUM DAILY LOAD MODELS THROUGH BACTERIAL SOURCE TRACKING1

ABSTRACT: Surface water impairment by fecal coliform bacteria is a water quality issue of national scope and importance. In Virginia, more than 400 stream and river segments are on the Commonwealth's 2002 303(d) list because of fecal coliform impairment. Total maximum daily loads (TMDLs) will be developed for most of these listed streams and rivers. Information regarding the major fecal coliform sources that impair surface water quality would enhance the development of effective watershed models and improve TMDLs. Bacterial source tracking (BST) is a recently developed technology for identifying the sources of fecal coliform bacteria and it may be helpful in generating improved TMDLs. Bacterial source tracking was performed, watershed models were developed, and TMDLs were prepared for three streams (Accotink Creek, Christians Creek, and Blacks Run) on Virginia's 303(d) list of impaired waters. Quality assurance of the BST work suggests that these data adequately describe the bacteria sources that are impairing these streams. Initial comparison of simulated bacterial sources with the observed BST data indicated that the fecal coliform sources were represented inaccurately in the initial model simulation. Revised model simulations (based on BST data) appeared to provide a better representation of the sources of fecal coliform bacteria in these three streams. The coupled approach of incorporating BST data into the fecal coliform transport model appears to reduce model uncertainty and should result in an improved TMDL.