Health-related quality of life 24 months after sustaining a minor musculoskeletal injury in a road traffic crash: A prospective cohort study

Objectives: A better understanding of the long-term factors that independently predict poorer quality of life following mild to moderate musculoskeletal injuries is needed. We aimed to establish the predictors of quality of life (including sociodemographic, health, psychosocial, and pre-injury factors) 24 months after a noncatastrophic road traffic injury.

Methods: In a prospective cohort study of 252 participants with mild/moderate injury sustained in a road traffic crash, quality of life was measured 24 months following the baseline survey. A telephone-administered questionnaire obtained information on various potential explanatory variables. Health-related quality of life was measured using the European Quality of Life–5 Dimensions (EQ-5D) and Medical Outcomes Survey Short Form–12 (SF-12). Multivariable linear regression analyses determined the associations between explanatory variables and quality of life measures.

Results: Mean SF-12 physical component summary (PCS) and mental component summary (MCS) scores increased by 7.3 and 2.5 units, respectively, from baseline to 24-month follow-up. Each 10-year increase in baseline age was independently associated with 3.1-unit (P < .001) and 1.5-unit (P = .001) decrease in EQ Visual Analogue Scale (VAS) and SF-12 PCS scores at follow-up, respectively. Poor/fair compared to excellent pre-injury health was associated with a 0.16-, 21.3-, and 11.5-unit decrease in EQ-5D summary (P = .03), VAS scores (P = .001), and SF-12 PCS scores (P < .001), respectively. Baseline pain severity ratings and pain catastrophizing scores were inversely associated with 24-month EQ VAS scores (both P < .001). Each unit increase in baseline pain score (P = .001) and pain catastrophizing score (P = .02) was associated with a 1.0- and 4.6-unit decrease in SF-12 MCS scores at 24 months, respectively. Other observed predictors of quality of life measures (EQ-5D summary and/or VAS scores and/ or SF-12 MCS) included marital status, smoking, hospital admission, pre-injury health (anxiety/depression and chronic illness), and whiplash injury.

Conclusion: Sociodemographic indicators, pre-injury health, and biopsychosocial correlates were independently associated with health-related quality of life 24 months following a noncatastrophic road traffic crash injury.     

Sustainability,education and local government: insights from the Australian state of Victoria

Local government (LG) is increasingly playing a role in tackling environmental issues and promoting sustainability. An important element of this LG focus is sustainability education and engagement, yet only few details on the nature of these activities are evident. Similarly there is little understanding of the professional competencies required by LG staff to deliver the relevant sustainability education and engagement activities. A web-based survey of LG sustainability officers in the State of Victoria (Australia) provides insight into the focus of these officers’ work and the competencies they rely on. The findings seek to guide the training and employment of LG sustainability staff and the effective delivery of sustainability education and engagement activities. Broadly, the sustainability officers surveyed are closely involved with activities within their LG organisation, but are engaging less so with specific education institutions, organisational sectors and the community in general. In keeping with this, the major sustainability education and engagement focuses are collaboration with peers and stakeholders, rather than community-wide initiatives. For undertaking sustainability education and engagement activities, systems-thinking, anticipatory competence and normative competence were highlighted as important; however, strategic competence and interpersonal competence were considered most important.     

Improving Habitat Models and Their Utility in Koala Conservation

Abstract: Models of what makes good koala habitat are a key to developing effective conservation policy and practices. Koala habitat models are based on (1) ecological studies of high-density koala populations in limited areas, (2) physiological studies of koala nutrition and characteristics of food plants, and (3) surveys of koala geographic distribution and biophysical features of forests and woodlands. The role of models in koala conservation varies because legislators, decisionmakers, land managers, and citizens have different expectations and uses for models. Although current habitat models address many of these needs, overall they lack sufficient certainty and authority to resolve disputes and develop policy. Unpublished and inadequately peer-reviewed data and models add to misinterpretation and argument. Improvements are needed in the decision-making process to increase the constructive involvement of all interest groups and to focus on the koala conservation problem, thereby reducing use of the popular media and courts of law to achieve objectives.     

Ozone and bean plants: morphology matters

Relationship between leaf morphology and cultivar sensitivity to ozone were established.     

Evaluation of geochemical methods for discrimination of metal contamination in Antarctic marine sediments: a case study from Casey Station

Detecting anthropogenic metal contamination in regional surveys can be particularly difficult when there is a lack of pre-disturbance data, especially when trying to differentiate low to moderate levels of contamination from background values. Furthermore, comparisons with other regional studies are confounded by differing analytical methods used and variations in sediment properties such as grainsize. Several types of geochemical technique, including weak acid partial extraction, strong acid extractions and total digestion have been used. Attempts have been made to overcome the influence that grainsize has on chemical concentrations in heterogeneous environments by analysing the fines, typically the mud fraction (<63 microm), in an attempt to improve the detection of anthropogenic contamination. Here we compare a weak acid partial extraction using 1M HCl and total digestion methods for a regional survey of reference and impacted sites in Antarctica using both whole sediment (<2 mm) and mud (<63 microm) fractions. The 1M partial extraction on whole sediment (<2 mm) most closely distinguished weakly, or moderately, impacted sites from reference locations. It also identified small scale within-location spatial variation in metal contamination that the total digest did not detect. Compared with total digests or analysis of the <63 microm fraction alone, this method minimised the possibility of a Type II statistical error in the regional survey - that is, failing to identify a site as being contaminated when it has elevated metal concentrations. To allow inter-regional comparison of sediment chemistry data from elsewhere in Antarctica, and also more generally, we recommend a 1M HCl partial extraction on whole sediment (<2 mm).     

Book reviews

The Economics of Art and Culture: An American Perspective

James Heilbrun & Charles M. Gray

New York, Cambridge University Press, 1993, 378 pp., £14.95 pb

Building Cities that Work

Edmund Fowler

Montreal & Kingston, McGill‐Queen's University Press, 1992, 315 pp.

Interactive Decision Making: The Graph Model for Conflict Resolution

Liping Fang, Keith W. Hipel & D. Marc Kilgour

New York, Wiley, 1993, 221 pp., £49.50

The Politics of Nature: Explorations in Green Political Theory

Andrew Dobson & Paul Lucardie (Eds)

London, Routledge, 1993, 240 pp. + xv, £37.50

Urban Transport in Asia: An Operational Agenda for the 1990s, World Bank

Technical Paper No. 224

Peter Midgley

Washington, DC, The World Bank, 1994, 98 pp.

Landscape Ecology: Theory and Application, 2nd edition

Zev Naveh & Arthur Lieberman

New York, Springer‐Verlag, £34.50     

Conservation resource allocation,small population resiliency,and the fallacy of conservation triage

Some conservation prioritization methods are based on the assumption that conservation needs overwhelm current resources and not all species can be conserved; therefore, a conservation triage scheme (i.e., when the system is overwhelmed, species should be divided into three groups based on likelihood of survival, and efforts should be focused on those species in the group with the best survival prospects and reduced or denied to those in the group with no survival prospects and to those in the group not needing special efforts for their conservation) is necessary to guide resource allocation. We argue that this decision-making strategy is not appropriate because resources are not as limited as often assumed, and it is not evident that there are species that cannot be conserved. Small population size alone, for example, does not doom a species to extinction; plants, reptiles, birds, and mammals offer examples. Although resources dedicated to conserving all threatened species are insufficient at present, the world's economic resources are vast, and greater resources could be dedicated toward species conservation. The political framework for species conservation has improved, with initiatives such as the UN Sustainable Development Goals and other international agreements, funding mechanisms such as The Global Environment Facility, and the rise of many nongovernmental organizations with nimble, rapid-response small grants programs. For a prioritization system to allow no extinctions, zero extinctions must be an explicit goal of the system. Extinction is not inevitable, and should not be acceptable. A goal of no human-induced extinctions is imperative given the irreversibility of species loss.