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.     

Implementation of resource management plans: identifying keys to success

One of the primary challenges in resource and environmental planning is successful implementation of plans. Plan implementation is a complex process influenced by many factors. This study identifies 19 criteria affecting implementation success and tests the impact of these criteria through a case study of collaborative plan implementation in British Columbia, Canada. The significance of criteria and degree to which they are met is assessed by a survey of senior officials responsible for plan implementation. An implementation evaluation index (IEI) is constructed to assess the quality of plan implementation systems and best practices for effective implementation are identified.     

低温试验能力验证中的不确定度分析评估

本文简述电气领域如何评定测量不确定度过程,并结合CNAS T0346低温试验能力验证计划,识别和具体分析低温试验中各测量不确定度的来源,对各种影响因素进行评价,论述人、机、料、法、环、测各环节对测量结果的影响,给出了低温试验测量结果不确定度的评估过程。     

区域规划环境影响跟踪评价的理论研究

随着环境影响评价制度的深入实施,其实施领域已由项目环评向区域环评和规划环评转变,评价内容也由广泛实施的预测评价向后评价和跟踪评价转变。然而,对于区域规划环评的评价层次、评价程序和评价内容,目前还没有明晰的认识;同时,对于促进规划环评有效实施的跟踪评价,其相关的理论和实践研究几乎没有。文中就此问题作了深入探讨。     

Three-Dimensional Modelling of Concentration Fluctuations in Complicated Geometry

The strong fluctuating component in the measured concentration time series of a dispersing gaseous pollutant in the atmospheric boundary layer, and the hazard level associated to short-term concentration levels, demonstrate the necessity of calculating the magnitude of turbulent fluctuations of concentration using computational simulation models. Moreover the computation of concentration fluctuations in cases of dispersion in realistic situations, such as built-up areas or street canyons, is of special practical interest for hazard assessment purposes. In this paper, the formulation and evaluation of a model for concentration fluctuations, based on a transport equation, are presented. The model is applicable in cases of complex geometry. It is included in the framework of a computational code, developed for simulating the dispersion of buoyant pollutants over complex geometries. The experimental data used for the model evaluation concerned the dispersion of a passive gas in a street canyon between 4 identical rectangular buildings performed in a wind tunnel. The experimental concentration fluctuations data have been derived from measured high frequency concentrations. The concentration fluctuations model is evaluated by comparing the model's predictions with the observations in the form of scatter plots, quantile-quantile plots, contour plots and statistical indices as the fractional bias, the geometrical mean variance and the factor-of-two percentage. From the above comparisons it is concluded that the overall model performance in the present complex geometry case is satisfactory. The discrepancies between model predictions and observations are attributed to inaccuracies in prescribing the actual wind tunnel boundary conditions to the computational code.     

太湖地区“禁磷”措施的效果及在富营养化控制中的作用

通过太湖地区采取“禁磷”措施前后城市生活污水、主要入湖河水和湖体水域中磷浓度与富营养化指数变化的分析 ,证实“禁磷”措施对降低居民生活污水中磷浓度的作用较为明显 ,降幅为 2 4 %左右 ,但对入湖河道和湖体水域中磷浓度与水体富营养化的影响则不明显。表明太湖富营养化的改善 ,除了实施“禁磷”措施外 ,尚需结合流域内其它污染治理措施 ,进行综合治理 ,才能取得较好的效果。     

Are we planning for sustainable disaster recovery? Evaluating recovery plans after the Wenchuan earthquake

This article examines local recovery plans that were created in response to the Wenchuan earthquake and then suggests ways that planners can better apply the concept of sustainability to the recovery process. We utilize a plan evaluation protocol to analyze 16 recovery plans in counties and towns that were severely affected by the earthquake. We also conducted semi-structured interviews with public officials and planners, with the qualitative data gleaned from these interviews being used to supplement the plan quality assessment. The results reveal that local recovery plans do not appear to have incorporated sufficiently the concepts of sustainability. We conclude the paper with the following recommendations: emphasizing sustainability as a policy priority during vision and goal development; developing solid databases and planning techniques; designing a diversified set of regulatory- and incentive-based policy tools suitable for local governments; enhancing social and institutional learning; and further integrating multi-level and interagency governmental units.     

Co-composting of livestock manure with rice straw: Characterization and establishment of maturity evaluation system

Composting is considered to be a primary treatment method for livestock manure and rice straw, and high degree of maturity is a prerequisite for safe land application of the composting products. In this study pilot-scale experiments were carried out to characterize the co-composting process of livestock manure with rice straw, as well as to establish a maturity evaluation index system for the composts obtained. Two pilot composting piles with different feedstocks were conducted for 3 months: (1) swine manure and rice straw (SM–RS); and (2) dairy manure and rice straw (DM–RS). During the composting process, parameters including temperature, moisture, pH, total organic carbon (TOC), organic matter (OM), different forms of nitrogen (total, ammonia and nitrate), and humification index (humic acid and fulvic acid) were monitored in addition to germination index (GI), plant growth index (PGI) and Solvita maturity index. OM loss followed the first-order kinetic model in both piles, and a slightly faster OM mineralization was achieved in the SM–RS pile. Also, the SM–RS pile exhibited slightly better performance than the DM–RS according to the evolutions of temperature, OM degradation, GI and PGI. The C/N ratio, GI and PGI could be included in the maturity evaluation index system in which GI > 120% and PGI > 1.00 signal mature co-composts.     

Chemical oxidation of sulfadiazine by the Fenton process: Kinetics,pathways, toxicity evaluation

This paper investigated sulfadiazine oxidation by the Fenton process under various reaction conditions. The reaction conditions tested in the experiments included the initial pH value of reaction solutions, and the dosages of ferrous ions and hydrogen peroxide. Under the reaction conditions with pH 3, 0.25 mM of ferrous ion and 2 mM of hydrogen peroxide, a removal efficiency of nearly 100% was achieved for sulfadiazine. A series of intermediate products including 4-OH-sulfadiazine/or 5-OH-sulfadiazine, 2-aminopyrimidine, sulfanilamide, formic acid, and oxalic acid were identified. Based on these products, the possible oxidation pathway of sulfadiazine by Fenton's reagent was proposed. The toxicity evaluation of reaction solutions showed increased antimicrobial effects following the Fenton oxidation process. The results from this study suggest that the Fenton oxidation process could remove sulfadiazine, but also increase solution toxicity due to the presence of more toxic products.