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.     

医疗废物焚烧处理核心技术的开发及应用

国内已建成的医疗废物焚烧设施目前普遍存在进料系统不稳定、玻璃结渣和高浓度HCl气体的排放的问题。这些技术难点已成为医疗废物焚烧处置行业发展的瓶颈。本文介绍了可解决上述问题的"可调节医疗废物恒流量进料技术"、"医废焚烧防玻璃结渣技术"和"含高浓度氯化氢医废尾气处理技术"三项医疗废物焚烧处理核心技术的主要特点及技术指标与应用实例。     

衡水市医疗废物处理现状调查及对策

医疗废物是一类成分复杂并有特殊危害的危险废弃物。通过分析衡水市医疗废物处理过程中存在的分散处置、处理率低等问题,提出了加强管理监督机制、提高医疗废物收集处理率的应对策略。通过综合比较分析几种医疗废物处理方法的优缺点,指出高温焚烧法集中处置是衡水市医疗废物的最佳处理方法。     

利益主体视角下的西部新农合制度运行困境分析

实现新农合制度设计的初衷目标、提升制度的惠农政策效果,是亟待解决的重大现实问题.为探寻制度实施效果与设计预期目标的偏差,科学厘清出影响西部新农合惠农政策效果的主要因素,本文基于西部10省区17县(区)的780份农户调研数据及相关统计数据,从医(医疗服务机构)、患(参合农民)、保(医疗保障机构)、管(政府)四方利益主体的视角,对西部新农合制度运行中的困境进行剖析.研究结果表明,既有的新农合制度运行框架模式,会陷入医疗服务机构行为扭曲与服务供给可及性差并存、医疗保障机构经办能力不足与保障效果欠佳并存、政府市场化导向与公共服务职能缺失并存、农民参合意愿强烈与被动参合并存的运行困境.三方强势主导形成的主体间利益失衡,必然影响到新农合的持续运行发展.因此,在新农合制度由试点普及向规范持续运行转轨的关键时期,必须以激励约束机制为突破,构建利益相关主体的协同联动改革机制,有效调动运行主体的积极性,实现新农合制度的持续运行.     

完善我国医疗废物集中处置收费政策的思考和建议

医疗废物处置收费政策是医疗废物处置产业化发展的重要前提和保障。当前,医疗废物处置收费政策执行难,欠费、漏费等问题非常突出,医疗废物集中收集十分困难。在对我国医疗废物处置收费政策进行全面分析和评估的基础上,对当前收费政策存在的主要问题和产生的原因进行了分析。以加快完善医疗废物处置收费政策为目标,从完善政策体系、加强监管执法、提高标准合理性、综合确定费用承担方、制定鼓励性的经济政策、提高宣传和缴费意识等方面,提出医疗废物处置收费政策改革完善的若干建议。     

Ants as a Measure of Effectiveness of Habitat Conservation Planning in Southern California

Abstract: In the United States multispecies habitat conservation plans were meant to be the solution to conflicts between economic development and protection of biological diversity. Although now widely applied, questions exist concerning the scientific credibility of the conservation planning process and effectiveness of the plans. We used ants to assess performance of one of the first regional conservation plans developed in the United States, the Orange County Central‐Coastal Natural Community Conservation Plan (NCCP), in meeting its broader conservation objectives of biodiversity and ecosystem‐level protection. We collected pitfall data on ants for over 3 years on 172 sites established across a network of conservation lands in coastal southern California. Although recovered native ant diversity for the study area was high, site‐occupancy models indicated the invasive and ecologically disruptive Argentine ant (Linepithema humile) was present at 29% of sites, and sites located within 200 m of urban and agricultural areas were more likely to have been invaded. Within invaded sites, native ants were largely displaced, and their median species richness declined by more than 60% compared with uninvaded sites. At the time of planning, 24% of the 15,133‐ha reserve system established by Orange County NCCP fell within 200 m of an urban or agricultural edge. With complete build out of lands surrounding the reserve, the proportion of the reserve system vulnerable to invasion will grow to 44%. Our data indicate that simply protecting designated areas from development is not enough. If habitat conservation plans are to fulfill their conservation promise of ecosystem‐level protection, a more‐integrated and systematic approach to the process of habitat conservation planning is needed.     

Biodiversity Conservation, Ecosystem Functioning, and Economic Incentives under Cocoa Agroforestry Intensification

Abstract:  World chocolate demand is expected to more than double by 2050. Decisions about how to meet this challenge will have profound effects on tropical rainforests and wild species in cocoa-producing countries. Cocoa, "the chocolate tree," is traditionally produced under a diverse and dense canopy of shade trees that provide habitat for a high diversity of organisms. The current trend to reduce or eliminate shade cover raises concerns about the potential loss of biodiversity. Nevertheless, few studies have assessed the ecological consequences and economic trade-offs under different management options in cocoa plantations. Here we describe the relationships between ant ecology (species richness, community composition, and abundance) and vegetation structure, ecosystem functions, and economic profitability under different land-use management systems in 17 traditional cocoa forest gardens in southern Cameroon. We calculated an index of profitability, based on the net annual income per hectare. We found significant differences associated with the different land-use management systems for species richness and abundance of ants and species richness and density of trees. Ant species richness was significantly higher in floristically and structurally diverse, low-intensity, old cocoa systems than in intensive young systems. Ant species richness was significantly related to tree species richness and density. We found no clear relationship between profitability and biodiversity. Nevertheless, we suggest that improving the income and livelihood of smallholder cocoa farmers will require economic incentives to discourage further intensification and ecologically detrimental loss of shade cover. Certification programs for shade-grown cocoa may provide socioeconomic incentives to slow intensification.     

建设项目环境影响的医学评价方法研究

作者在对中国我人民解放军第４７医院病建项目所产生的大气环境影响进行了医学秤价和影响，并在预测的基础上，建立了完整的环境医学影响廉政价方法，由于该评价方法完全尊循了国内现行大气环境影响评价的基本要求和程序，因此，它在今后的环境影响医学评价中净有广泛的应用。     

WATER RESOURCES AND HUMAN HEALTH: THE VIEWPOINT OF MEDICAL GEOGRAPHY1

ABSTRACT: Medical geography studies both areal patterns of human health and disease and the environmental and cultural factors that contribute to such conditions. In such studies water resources are of major importance, not only because they are essential for life and their scenic beauty is of inspirational value, but also because they are involved, directly or indirectly, in more than 80 percent of all disease. The direct involvements result from various disease causing agents sometimes found in surface or ground water organic ones such as bacteria, worms, etc., which are known as pathogens, and inorganic ones such as trace elements and synthetic toxic chemicals. Surface waters may have indirect effects also, for they may serve as habitats or breeding places for organisms that do not themselves cause human disease but that serve as vectors or hosts for such pathogens. This paper will discuss these various roles of water resources in both endemic and epidemic disease occurrences and ways in which various human activities domestic, economic, recreational, or religious — increase or reduce our exposure to such diseases.     

医疗废物制备木酢液及其成分分析

为了解以医疗废物为原料的木酢液制备特性和木酢液的成分,采用磁化热解装置进行调制试验,收集了热解冷凝液,并采用GC-MS对冷凝液的成分进行了分析。检测出有机酸、酚、醛、酮、酯等38种有机成分,并采用面积归一化法对主要成分进行定量分析。结果表明,医疗废物磁化热解冷凝液中的成分种类与木酢液十分接近,特别是乙酸(18.48%)与苯酚(5.15%)的含量较高,证明了依靠磁化空气热解医疗废物制备木酢液的可行性。而两者之间存在的成分差异对其功用的影响则有待进一步探究。