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.     

The Iowa Graduated Driver Licensing program: effectiveness in reducing crashes of teenage drivers

PROBLEM: Graduated Driver Licensing (GDL) programs vary in the United States in terms of implementation and restrictions. The State of Iowa's GDL program is assessed for its effectiveness in reducing crashes among teenage drivers. METHOD: Time series analysis was used to evaluate police documented crashes involving 16-, 17-, and 18-year-old drivers over a 10 year period, with an intervention identified at the point of GDL implementation. RESULTS: After controlling for seasonal trends and auto-correlative effects, a significant reduction in the crash rate of and 16- and 17-year-old drivers was observed due to the GDL implementation. However, there were no significant reductions in crash rates for 18-year-old drivers. DISCUSSION: The analyses suggest that the Iowa GDL program is effective in reducing the crash rates of 16- and 17-year-old drivers but the effects do not sustain for 18-year-old drivers. IMPACT ON INDUSTRY: The results suggest that the program appears to be working, however further analysis is needed to determine what factors are preventing lasting effects for these teenage drivers.     

Meta‐analytic tests of relationships between organizational justice and citizenship behavior: testing agent‐system and shared‐variance models

Research on the unique effects of different types of perceived fairness on citizenship behavior that benefits individuals (organizational citizenship behavior (OCB‐I) and organizations (OCB‐O) has produced mixed results. We assert that how OCB‐O and OCB‐I are conceptualized affects the patterns of results, and we hypothesize that, when OCB is conceptualized appropriately, an agent‐system model is supported (interactional and procedural justice are the strongest unique predictors of OCB‐I and OCB‐O, respectively). We also hypothesize that shared variance among the justice types explains additional variance in OCB. Analyses of semi‐ partial correlations conducted on meta‐analytic coefficients supported our hypotheses. Theoretical and practical implications are discussed. Copyright © 2007 John Wiley & Sons, Ltd.     

Urban observatories opportunities for environmental monitoring: solid wastes

Towns concentrate around 50% of world-wide population and the trend is oriented to underscore an urban profile of population. In addition, towns have become important for their economic contribution to the Gross Internal Product. The negative side of towns is the environmental and social impacts as a result of productive and domestic activities, besides the lack of available data. In order to overcome these shortcomings, the United Nations has established a project of urban monitoring throughout the Global Network of Urban Observatories; Mexico joined the project in 2005. The Local Urban Observatory of Mexicali has the task to produce information about cities that is useful to design public policies. Some of this information deals with a set of environmental indicators in the United Nations Habitat Agenda, which includes solid wastes. Therefore, this paper deals with two main topics; firstly, from the Habitat Agenda, a comparative urban analysis of waste production and coverage of domestic waste collection services; secondly, from the Local Agenda, the identification and ranking of environmental problems according to public perception coming from people involved in the municipal planning and decision making process. Results will be used to develop local indicators and public environmental policies.     

Processing and Properties of Mixtures of PHB-V with Post-consumer LDPE

Mixtures of poly-β-(hydroxybutyrate-co-valerate) PHB-V with virgin and post-consumer low density polyethylene (LDPE) were prepared by melt mixing in proportions of 100/0, 90/10, 80/20, 70/30 and 0/100 (wt/wt%). The mixtures were analysed by infrared spectroscopy, differential scanning calorimetry (DSC), dynamic mechanical thermal analysis (DMTA), melting flow index (MFI), tensile tests, scanning electron microscopy (SEM) and biodegradation in simulated soil. The DMTA and DSC curves of post-consumer LDPE suggested that this polymer was a mixture of LDPE and linear low density polyethylene (LLDPE). Virgin and post-consumer LDPE had lower MFI than PHB-V, but the blends showed higher index as the content of LDPE increased. The addition of LDPE reduced the tensile strength and Young’s modulus of the mixtures compared with PHB-V. SEM indicated poor interfacial adhesion between PHB-V and LDPE. PHB-V degraded slow and gradually, while both LDPE showed virtually no degradation under the conditions studied. The biodegradability of the blends depended on their composition and of the type of LDPE. LDPE improved the biodegradability of the mixtures.     

Agricultural Chemicals in the Alluvial Aquifer of a Typical County of the Arkansas Delta

Statistical methods and a Geographic Information System (GIS) were used to investigate potential indicators of ground water vulnerability to agricultural chemical contamination in a representative area of the Mississippi River alluvial aquifer. A total of 47 wells were sampled for analysis of nitrate, phosphorus, potassium, and 13 pesticides commonly-used in the area. Ten soil and hydrogeologic variables and five ground water vulnerability indices were examined to explain the variations of chemical concentrations. The results showed that no individual soil or hydrogeologic variables or their linear combinations could explain more than 25% of the variation of the chemical concentrations. A quadratic response surface model with the values of confining unit thickness, slope, soil permeability, depth to ground water, and recharge rate accounted for 62% of the variation of nitrate, 43% of P, and 83% of K, suggesting that the interactions among soil and hydrogeologic variables were significant. Observed trends of decreasing nitrate and P concentrations with increasing well depth and/or depth to ground water seemed to correlate with carbonate equilibrium in the aquifer and more reduced environment with depth. In view of uncertainties involved, it was recognized that the limitations associated with input data resolution used in GIS and the formulation of leaching indices limited their use for predicting ground water vulnerability. Misuse of pesticides could be another factor that would complicate the relationships between pesticide concentrations and the vulnerability indices.