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.     

Environmental evaluation for workplace violence in healthcare and social services

PROBLEM: Federal policy recommends environmental strategies as part of a comprehensive workplace violence program in healthcare and social services. The purpose of this project was to contribute specific, evidence-based guidance to the healthcare and social services employer communities regarding the use of environmental design to prevent violence. METHOD: A retrospective record review was conducted of environmental evaluations that were performed by an architect in two Participatory Action Research (PAR) projects for workplace violence prevention in 2000 and, in the second project in 2005. Ten facility environmental evaluation reports along with staff focus group reports from these facilities were analyzed to categorize environmental risk factors for Type II workplace violence. RESULTS: Findings were grouped according to their impact on access control, the ability to observe patients (natural surveillance), patient and worker safety (territoriality), and activity support. DISCUSSION: The environmental assessment findings reveal design and security issues that, if corrected, would improve safety and security of staff, patients, and visitors and reduce fear and unpredictability. IMPACT ON INDUSTRY: Healthcare and social assistance employers can improve the effectiveness of violence prevention efforts by including an environmental assessment with complementary hazard controls.     

Morphological and genetic adaptation to a lagoon environment: a case study in the bryozoan genus Alcyonidium

The Fleet (southern England) is a stable (ca. 5,000 years) coastal saline lagoon that supports a population of Alcyonidium resembling the common coastal epiphyte, Alcyonidium gelatinosum (L.). A combination of morphological, reproductive, and ecological characters was used to compare lagoonal and non-lagoonal proximate populations. Comparisons revealed a difference in the timing of spawning, considered to be related to the temporally restricted availability of viable substrata within the lagoonal basin. Allochronous spawning and spatial separation together suggest that the lagoonal taxon is reproductively isolated. The two populations were further compared with seven other coastal populations of Alcyonidium using randomly amplified polymorphic DNA (RAPD) analysis. The results confirm the individuality of the lagoonal taxon but also a close relationship with three A. gelatinosum populations. We present and consider four hypotheses that may account for the presence of this genetically distinct taxon: (1) diversification within the Fleet; (2) colonisation from another lagoon; (3) non-indigenous species status; and (4) introduction by shipping or other anthropogenically mediated dispersal mechanism. Significant diversification on the time scale involved has been demonstrated for isolated freshwater environments and, therefore, is feasible within a saline lagoon. Hypothesis 1 and, to a lesser extent, hypothesis 2 are consistent with the recognition of individual lagoons as 'biogeographic' islands of importance for their unique or characteristic biodiversity. The study also represents the first example of concordant morphological, reproductive, and genetic diversification in a marine bryozoan.     

Speciation of selected heavy metals geochemistry in surface sediments from Tirumalairajan river estuary, east coast of India

Surface sediment samples from the Tirumalairajan river estuary were studied for grain size pattern, organic matter, and heavy metals (Fe, Mn, Zn, and Pb) using the sequential and bulk metal extraction methods to evaluate metal behavior. Ten surface sediment samples were collected during the monsoon and summer seasons of the year 2009. The observed orders of concentrations of heavy metals in the sediments were as follows: Fe?>?Mn?>?Zn?>?Pb. The results obtained from sequential extraction showed that, among the metals studied, a larger portion of the metals were associated with the residual phase, although they are available in other fractions. The low concentration of metals available in bioavailable phases indicated that the sediments of Tirumalairajan river estuary were relatively unpolluted. Correlation analysis was also carried out to understand the associations of metals in different phases with sand, silt, clay, and organic matter. To understand the risk of heavy metals to sediment-dwelling organisms, the data were compared with risk assessment code and sediment quality values using the screening quick reference table. The main source of metals to the estuary is from the irrigation field and its associated activities in the study area.     

Trends in land use and land cover change in the protected and communal areas of the Zambezi Region,Namibia

Land management decisions have extensively modified land use and land cover in the Zambezi Region. These decisions are influenced by land tenure classifications, legislation, and livelihoods. Land use and land cover change is an important indicator for quantifying the effectiveness of different land management strategies. However, there has been no evidence on whether protected or communal land tenure is more affected by land use and land cover changes in southern Africa and particularly Namibia. Our study attempted to fill this gap by analyzing the relationship between land use and land cover change and land tenure regimes stratified according to protected and communal area in the Zambezi Region. Multi-temporal Landsat TM and ETM+ imagery were used to determine the temporal dynamics of land use and land cover change from 1984 to 2010. The landscape showed distinctive modifications over the study period; broad trends include the increase in forest land after 1991. However, changes were not uniform across the study areas. Two landscape development stages were deduced: (1) 1984–1991 represented high deforestation and gradual increase in shrub land; (2) 1991–2000 and 2000–2010 represented lower deforestation and slower agropastoral expansion. The results further show clear patterns of the dynamics, magnitude, and direction of land use and land cover change by tenure regime. The study concluded that land tenure has a direct impact on land use and land cover, since it may restrict some activities carried out on the land in the Zambezi Region.     

Responses of Physical, Chemical, and Biological Indicators of Water Quality to a Gradient of Agricultural Land Use in the Yakima River Basin, Washington

The condition of 25 stream sites in the Yakima River Basin, Washington, were assessed by the U.S. Geological Survey's National Water-Quality Assessment Program. Multimetric condition indices were developed and used to rank sites on the basis of physical, chemical, and biological characteristics. These indices showed that sites in the Cascades and Eastern Cascades ecoregions were largely unimpaired. In contrast, all but two sites in the Columbia Basin ecoregion were impaired, some severely. Agriculture (nutrients and pesticides) was the primary factor associated with impairment and all impaired sites were characterized by multiple indicators of impairment. All indices of biological condition (fish, invertebrates, and algae) declined as agricultural intensity increased. The response exhibited by invertebrates and algae suggested a threshold response with conditions declining precipitously at relatively low levels of agricultural intensity and little response at moderate to high levels of agricultural intensity. This pattern of response suggests that the success of mitigation will vary depending upon where on the response curve the mitigation is undertaken. Because the form of the community condition response is critical to effective water-quality management, the National Water-Quality Assessment Program is conducting studies to examine the response of biota to gradients of land-use intensity and the relevance of these responses to water-quality management. These land-use gradient pilot studies will be conducted in several urban areas starting in 1999.     

Characterization of As and trace metals embedded in PM10 particles in Puebla City, México

Forty-eight air-filter samples (PM₁₀) were analysed to identify the concentration level of partially leached metals (PLMs; As, Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb and V) from Puebla City, México. Samples were collected during 2008 from four monitoring sites: (1) Tecnológico (TEC), (2) Ninfas (NIN), (3) Hermanos Serdán (HS) and (4) Agua Santa (AS). The results indicate that in TEC, As (avg. 424 ng m^?3), V (avg. 19.2 ng m^?3), Fe (avg. 1,202 ng m^?3), Cu (avg. 86.6 ng m^?3), Cr (41.9 ng m^?3) and Ni (18.6 ng m^?3) are on the higher side than other populated regions around the world. The enrichment of PLMs is due to the industrial complexes generating huge dust particles involving various operations. The results are supported by the correlation of metals (Mn, Cd and Co) with Fe indicating its anthropogenic origin and likewise, As with Cd, Co, Fe, Mn, Pb and V. The separate cluster of As, Fe and Mn clearly signifies that it is due to continuous eruption of fumaroles from the active volcano Popocatépetl in the region.     

Predicting occurrence of juvenile shark habitat to improve conservation planning

Fishing and habitat degradation have increased the extinction risk of sharks, and conservation strategies recognize that survival of juveniles is critical for the effective management of shark populations. Despite the rapid expansion of marine protected areas (MPAs) globally, the paucity of shark‐monitoring data on large scales (100s–1000s km) means that the effectiveness of MPAs in halting shark declines remains unclear. Using data collected by baited remote underwater video systems (BRUVS) in northwestern Australia, we developed generalized linear models to elucidate the ecological drivers of habitat suitability for juvenile sharks. We assessed occurrence patterns at the order and species levels. We included all juvenile sharks sampled and the 3 most abundant species sampled separately (grey reef [Carcharhinus amblyrhynchos], sandbar [Carcharhinus plumbeus], and whitetip reef sharks [Triaenodon obesus]). We predicted the occurrence of juvenile sharks across 490,515 km² of coastal waters and quantified the representation of highly suitable habitats within MPAs. Our species‐level models had higher accuracy (? ≥ 0.69) and deviance explained (≥48%) than our order‐level model (? = 0.36 and deviance explained of 10%). Maps of predicted occurrence revealed different species‐specific patterns of highly suitable habitat. These differences likely reflect different physiological or resource requirements between individual species and validate concerns over the utility of conservation targets based on aggregate species groups as opposed to a species‐focused approach. Highly suitable habitats were poorly represented in MPAs with the most restrictions on extractive activities. This spatial mismatch possibly indicates a lack of explicit conservation targets and information on species distribution during the planning process. Non‐extractive BRUVS provided a useful platform for building the suitability models across large scales to assist conservation planning across multiple maritime jurisdictions, and our approach provides a simple for method for testing the effectiveness of MPAs.