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.     

Soil and vegetation carbon stocks in Brazilian Western Amazonia: relationships and ecological implications for natural landscapes

The relationships between soils attributes, soil carbon stocks and vegetation carbon stocks are poorly know in Amazonia, even at regional scale. In this paper, we used the large and reliable soil database from Western Amazonia obtained from the RADAMBRASIL project and recent estimates of vegetation biomass to investigate some environmental relationships, quantifying C stocks of intact ecosystem in Western Amazonia. The results allowed separating the western Amazonia into 6 sectors, called pedo-zones: Roraima, Rio Negro Basin, Tertiary Plateaux of the Amazon, Javari-Juruá-Purus lowland, Acre Basin and Rondonia uplands. The highest C stock for the whole soil is observed in the Acre and in the Rio Negro sectors. In the former, this is due to the high nutrient status and high clay activity, whereas in the latter, it is attributed to a downward carbon movement attributed to widespread podzolization and arenization, forming spodic horizons. The youthful nature of shallow soils of the Javari-Juruá-Purus lowlands, associated with high Al, results in a high phytomass C/soil C ratio. A similar trend was observed for the shallow soils from the Roraima and Rondonia highlands. A consistent east–west decline in biomass carbon in the Rio Negro Basin sector is associated with increasing rainfall and higher sand amounts. It is related to lesser C protection and greater C loss of sandy soils, subjected to active chemical leaching and widespread podzolization. Also, these soils possess lower cation exchangeable capacity and lower water retention capacity. Zones where deeply weathered Latosols dominate have a overall pattern of high C sequestration, and greater than the shallower soils from the upper Amazon, west of Madeira and Negro rivers. This was attributed to deeper incorporation of carbon in these clayey and highly pedo-bioturbated soils. The results highlight the urgent need for refining soil data at an appropriate scale for C stocks calculations purposes in Amazonia. There is a risk of misinterpreting C stocks in Amazonia when such great pedological variability is not taken into account.     

Heavy metals in water, sediment and tissues of Liza saliens from Esmoriz–Paramos lagoon, Portugal

Esmoriz–Paramos lagoon is an ecosystem of great ecological importance that is located on the northwest coast of Portugal and has been degraded as a result of industrial and anthropogenic activities. Concentrations of heavy metals (Cr, Cu, Pb and Zn) were measured in water, sediment and in tissues (liver and muscle) of Liza saliens, which is the dominant fish from the lagoon. Comparisons between metal concentrations in water and sediments were made with those in tissues of fish caught at the lagoon. Metals in water were quantified predominantly bound to particulate and equalled or exceeded the limit of chronic reference values. Metal concentrations in sediments varied among sampled sites. The relative order of concentrations was “Zn > Cu ∼ Pb > Cr” the same pattern observed for metals in water. Metals in fish tissues showed higher concentrations in liver (262 mg Cu·Kg⁻¹ and 89 mg Zn·Kg⁻¹) than in muscle (<3 mg Cu·Kg⁻¹ and 26 mg Zn·Kg⁻¹), while Pb and Cr were not detected. These results suggest that Cu and Zn are the metals of major concern in the lagoon. Mullet detritivorous feeding habits, bioaccumulation pattern and the high sediment metals concentrations relative to the water suggest that sediments can be the most important source of contamination in this ecosystem. The positive relationship found between Cu in liver and fish length demonstrates that time of exposure is a crucial factor in bioaccumulation. Condition indices (K and HSI) in mullets from the lagoon were higher compared to mullets from sea, suggesting abnormal condition in the lagoon population. We conclude that metals chronic exposure in the lagoon can impose considerable fish stress. The results also show that the lagoon is an area of environmental concern.     

Mixed response in bacterial and biochemical variables to simulated sand mining in placer-rich beach sediments,Ratnagiri, West coast of India

We investigated the influence on bacterial community and biochemical variables through mechanical disturbance of sediment-akin to small-scale mining in Kalbadevi beach, Ratnagiri, a placer-rich beach ecosystem which is a potential mining site. Changes were investigated by comparing three periods, namely phase I before disturbance, phase II just after disturbance, and phase III 24 h after disturbance as the bacterial generation time is ≤7 h. Cores from dune, berm, high-, mid-, and low-tide were examined for changes in distribution of total bacterial abundance, total direct viability (counts under aerobic and anaerobic conditions), culturability and biochemical parameters up to 40 cm depth. Results showed that bacterial abundance decreased by an order from 10⁶ cells g^− 1 sediment, while, viability reduced marginally. Culturability on different-strength nutrient broth increased by 155% during phase II. Changes in sedimentary proteins, carbohydrates, and lipids were marked at berm and dune and masked at other levels by tidal influence. Sedimentary ATP reduced drastically. During phase III, Pearson’s correlation between these variables evolved from non-significant to significant level. Thus, simulated disturbance had a mixed effect on bacterial and biochemical variables of the sediments. It had a negative impact on bacterial abundance, viability and ATP but positive impact on culturability. Viability, culturability, and ATP could act as important indicators reflecting the disturbance in the system at short time intervals. Culturability, which improved by an order, could perhaps be a fraction that contributes to restoration of the system at bacterial level. This baseline information about the potential mining site could help in developing rational approach towards sustainable harnessing of resources with minimum damage to the ecosystem.     

Nutrient baselines of Cerrado low-order streams: comparing natural and impacted sites in Central Brazil

The aquatic systems responsible for water supply in the Brazilian Federal District (FD) have been threatened by anthropogenic pressures, especially considering the expressive demographic increase in the region during the last decades. The purposes of this research were: (a) to assess the water quality in streams located in the FD by monitoring physical–chemical variables; (b) to define baselines for these variables among different ecological status categories. The 14 investigated streams were sampled between 2006 and 2009, in the dry (August–September, 2006, 2008, 2009) and rainy (March–April, 2008, 2009) seasons. All sampling sites were classified in four categories (“very impacted”, “impacted”, “in transition” and “natural”) using an adaptation of a rapid habitat assessment protocol. Differences in water quality among sites were generally well predicted in the four ecological status categories defined by the protocol, which showed a gradient in nutrient concentrations from reference sites classified as “natural” (medians: electrical conductivity?=?7.3 μS cm^?1; nitrate?=?0.040 mg L^?1; ammonium?=?0.039 mg L^?1; soluble reactive phosphorus (SRP)?=?<0.001 mg L^?1; total phosphorus (TP)?=?0.006 mg L^?1; ) to those classified as “very impacted” (medians: electrical conductivity?=?87.7 μS cm^?1; nitrate?=?0.247 mg L^?1; ammonium?=?0.219 mg L^?1; SRP?=?0.010 mg L^?1; TP?=?0.035 mg L^?1). Point sources inputs were the main factor for water quality deterioration. The nutrient baselines reported were relatively low when compared to data collected from reference areas in Brazil (e.g., São Paulo State) or temperate regions, especially for TP.     

Assessing the ecological condition of streams in a southeastern Brazilian basin using a probabilistic monitoring design

Prompt assessment and management actions are required if we are to reduce the current rapid loss of habitat and biodiversity worldwide. Statistically valid quantification of the biota and habitat condition in water bodies are prerequisites for rigorous assessment of aquatic biodiversity and habitat. We assessed the ecological condition of streams in a southeastern Brazilian basin. We quantified the percentage of stream length in good, fair, and poor ecological condition according to benthic macroinvertebrate assemblage. We assessed the risk of finding degraded ecological condition associated with degraded aquatic riparian physical habitat condition, watershed condition, and water quality. We describe field sampling and implementation issues encountered in our survey and discuss design options to remedy them. Survey sample sites were selected using a spatially balanced, stratified random design, which enabled us to put confidence bounds on the ecological condition estimates derived from the stream survey. The benthic condition index indicated that 62 % of stream length in the basin was in poor ecological condition, and 13 % of stream length was in fair condition. The risk of finding degraded biological condition when the riparian vegetation and forests in upstream catchments were degraded was 2.5 and 4 times higher, compared to streams rated as good for the same stressors. We demonstrated that the GRTS statistical sampling method can be used routinely in Brazilian rain forests and other South American regions with similar conditions. This survey establishes an initial baseline for monitoring the condition and trends of streams in the region.     

Environmental radiological impact associated with non-uranium mining industries: a proposal for screening criteria

Niobium, phosphate, coal and gold mining facilities have been selected as case studies with the aim of identifying possible sources of radiological impact during and after cessation of industrial operations. The results have shown that acid drainage, as well as chemical processing of mineral ores, constitute relevant impact indicators for present-day and future scenarios. The possible use of solid wastes abandoned at the end of the operations represents a long-term radiological concern. Therefore, it is necessary that Brazilian legislation for environmental licensing be revised taking into account the potential environmental and radiological impacts caused by these industries and establishing remedial procedures for waste storage areas in the existing sites. The indicators developed and procedures carried out can be used in screening for decisions on the adoption of regulatory requirements for practices at such types of installations.     

Enzymatic transformation and binding of labeled 2,4,6-trinitrotoluene to humic substances during an anaerobic/aerobic incubation

Organic pollutants are degraded in soil and simultaneously nonextractable residues are formed. However, proof is lacking that this fixation has a detoxifying effect. We investigated the transformation and binding of 2,4,6-trinitrotoluene (TNT) with catechol or soil humic acid as cosubstrates. Carbon-14-labeled TNT and its reaction products were quantified by radiocounting; extractable compounds were identified by high performance liquid chromatography (HPLC). Bound and extractable residues of 15N-labeled TNT and metabolites were studied by 15N nuclear magnetic resonance spectroscopy (15N NMR). Since TNT is not easily transformed under oxidizing conditions an anaerobic/aerobic treatment was used. Anaerobic microorganisms from cow manure were used to reduce TNT during the anaerobic phase and subsequently, a laccase from Trametes villosa was used in the aerobic phase to oxidatively couple the metabolites to humic matter. Seventy-four percent of TNT was immobilized with catechol as cosubstrate, but only 25% with humic acid. With catechol the main extractable component was TNT, while with humic acid it was mostly the metabolite 4-aminodinitrotoluene. For both co-substrates, the spectra of immobilized metabolites obtained by solid-state 15N-cross polarization magic angle spinning (CPMAS) NMR spectroscopy showed signals in the chemical shift region for protonated aromatic amino compounds. However, in the presence of catechol, an additional signal from nonextractable nitro groups was found, which could represent sequestered TNT. The partially reduced metabolites of TNT that formed nonextractable residues in humic acid are not likely to be remobilized easily and are thus regarded as detoxified.     

Mainstreaming climate change adaptation at the local level

National authorities in many countries aim at having climate change adaptation mainstreamed into existing policy domains in order to achieve coherence and synergies, and to avoid mal-adaptation. Because of local variations in climate change impacts, the lion's share of climate adaptation work will have to take place at the local level. This means also that the mainstreaming process needs to occur locally. This article examines the mainstreaming of climate change adaptation into existing sectors in five Norwegian municipalities. Applying theories of mainstreaming and policy integration we find that policy development is slower, but perhaps more robust in the municipalities that have chosen a horizontal, cross-sectoral approach to mainstreaming than in the municipalities that have chosen a vertical sector approach to mainstreaming.     

Critical engagement,activist/academic subjectivities and organic agri-food research in Uganda

This paper provides a reflexive account of engagement in activist/academic organic agri-food research in Uganda. I argue that critical engagement across the third space – between and across activist and academic subjectivities – enables a re-thinking of the subjectivities of activist/academics and research participants and the place of research in social change and theory building. I demonstrate some of the multiple ways of enacting activism within the academy by reflecting on my critical engagement with the Katuulo Organic Pineapple Cooperative in Uganda, whose members grow certified organic pineapples for sale on the international market. While there is a growing interest in critical activist research, its agenda is also constrained by the corporatist turn in universities. As such, the subjectivities, methods and theory building of activist/academics in agri-food (and other) research represents part of the resistance to normalised ways of doing and being in contemporary neo-liberal universities.