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.     

Evaluation of a healthcare safety climate measurement tool

Problem

Psychometrically validated measurement tools are needed to evaluate an organization's safety climate. In 2000, Gershon and colleagues published a new healthcare safety climate measurement tool to determine its relationship to safe work behavior (Gershon, R., Karkashian, C., Grosch, J., Murphy, L., Escamilla-Cejudo, A., Flanagan, P., et al. (2000). Hospital safety climate and its relationship with safe work practices and workplace exposure incidents. American Journal of Infection Control, 28, 211-21). The present study evaluated the psychometric properties of the Gershon tool when modified to address respiratory rather than bloodborne pathogen exposures.

Method

Medical practitioners, nurses, and nurse aides (n = 460) were surveyed using the modified Gershon tool. Data were analyzed by factor analysis and psychometric properties of the tool evaluated.

Results

Eight safety climate dimensions were extracted from 25 items (Cronbach's alpha range: 0.62 - 0.88). Factor extractions and psychometric properties were reasonably consistent with those of the Gershon tool.

Impact on Industry

The Gershon safety climate tool appears to have sufficient reliability and validity for use by healthcare decision makers as an indicator of employee perceptions of safety in their institution.     

Integrated coastal management: top-down vs. community-based approaches

In this paper, a dynamic model is developed in which coastal quality can be improved, restored, or maintained by two distinct user groups; this is done by identifying a context that ensures an increase (or a greater increase) in coastal quality in terms of specific features that characterise the user groups. The results demonstrate that integrated coastal management is always better than non-integrated management. Moreover, when there is a low degree of interest in maintaining the coastal use over time, only integrated community-based (CB) coastal management will increase the coastal quality. Even when the interest in maintaining the coastal use over time is high, an integrated CB approach is preferred if the willingness to pay for coastal improvements is great and the marginal inefficiency of investments in coastal improvements is low, because the coastal quality improves to a greater extent; if not, only an integrated top-down (TD) approach to coastal management will increase the coastal quality. These results suggest that developing countries should always adopt a CB approach; in contrast, developed countries should adopt a CB approach where local stakeholders attach direct values to the coastal quality, and adopt a TD approach where the general population attaches indirect (option or existence) values to coastal quality.     

城市防震减灾能力评估研究

首先论述了目前国内外关于城市地震灾害风险评估的研究,分析了这些研究取得的成果和存在的不足。然后,提出了城市防震减灾能力的概念,采用人员伤亡,经济损失和震后恢复时间作为衡量城市防震减灾能力强弱的3个最基本的要素。围绕这3个基本要素,列举出影响城市防震减灾能力的6大因素,在此基础上,提出了城市防震减灾能力评价指标体系的具体内容。     

对南京市发展绿色经济的思考

简述了发展绿色经济的重要性,指出了南京市发展绿色经济的有利条件及存在问题。提出,南京发展绿色经济,必须树立绿色发展理念,推动科学发展实践;制定绿色发展战略,推进可持续发展;支持绿色技术研发,培育新经济增长点;打造绿色优势产业,促进结构向高端转型;倡导绿色消费行为,推进资源节约、环境友好型社会建设;建立健全绿色制度,提供经济社会发展保障。     

Community participation in cultural heritage and environmental policy formulation in Botswana

Cultural heritage does not have direct economic benefits. However, if properly managed it can stimulate social cohesions, improving the environment and have beneficial economic spin offs for the local communities. This paper discusses the role of communities in the formulation of the policies concerning their local environment. It argues that community engagement by policy makers is important in giving legitimacy and ownership of the policies. Furthermore, this paper discusses the potential of cultural heritage in diversifying the economy in Botswana. This paper recommends for the re-assessment of the relationship between the state and local communities which is critical in resuscitating the seemingly ailing community business organizations. In conclusion, it argues for the sustainable management of cultural heritage as a social and economic resource in the next 50 years of Botswana’s independence.     

基于可拓物元模型的安全经济开采评价指标体系的构建及应用

首先根据安全经济开采的内涵,建立以人员安全、设施设备安全、开采环境安全、安全投资和安全管理为主要制约因素的安全经济开采评价模型,并运用改进的层次分析法确定人员可靠度对安全经济开采水平影响最大,开采环境可靠度影响最小。其次,采用函数拟合法、专家打分法、标准化打分法量化安全经济开采水平指标,并将安全经济开采水平划分为3个等级。最后,运用可拓物元模型方法,得出某铁矿安全经济开采水平为二级,无重大经济损失,与实际吻合。     

A multi-objective design optimisation of eco-friendly aircraft: the impact of noise fees on airplanes sustainable development

The current work deals with multi-objective optimisations including financial merit factors in the multi-disciplinary conceptual design of a commercial aircraft with a specific focus on noise social cost. The results of optimisations using financial and performance-oriented objective functions have been analysed and combined in a multi-objective optimisation problem using a three-dimensional objective vector. The main novelty of the present work is the analysis of social cost noise fees effectiveness integrated in financial models embracing a wider group of stakeholders’ interests. The foundations of this research lie on the air traffic increase envisaged in the next decades and the contextual growth of the urban areas nearby airport facilities. This scenario requires the aeronautical industry to handle the environment challenge taking into account all the social and economic effects. Indeed, the consolidated technology has approached a saturation point, therefore breakthrough concepts and configurations are mandatory. This matter is addressed as a highly multi-disciplinary problem within conceptual design framework. The financial model proposed is shown to highlight the need of appropriate noise fees as instruments to push all stakeholders towards a technology radical renewal and encourage the aeronautical industry towards a shared strategy in the development of an eco-friendly commercial aviation system.     

The channels of the effect of government expenditure on the environment: evidence using dynamic panel data

This paper explores the relationship between government spending and environmental quality using panel data for 94 countries for the period 1970–2008. We identify and estimate three distinct channels that comprise the total direct effect of government expenditure on air pollution, namely a marginal effect, an effect conditional on economic growth and an effect conditional on institutional quality. Since adjustment rate of emissions to their equilibrium level is slow due to technological and institutional reasons, we explicitly take into account dynamics by applying appropriate econometric methods. The results demonstrate that there is a significant alleviating direct effect of government expenditure on SO₂ and NO_x emissions, which increases with the level of economic growth and democracy. However, there is no evidence of a significant effect on pollutants with more global impact on the environment and human health, like N₂O and CO₂, implying that the adoption of international environmental treaties is required in this case.