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.     

Is energy efficiency capitalized into home prices? Evidence from three U.S. cities

We test for evidence that energy efficiency features are capitalized into home prices in three U.S. metropolitan areas. Using hedonic regressions and multiple matching procedures, we find that Energy Star certification is associated with higher sales prices in two of the markets: the Research Triangle region of North Carolina and Portland, Oregon. We find that local “green” certifications in Portland and in Austin, Texas, are also associated with higher prices and that the estimated price impacts are larger than those from Energy Star. Matching on observables proves to be important in some cases, reducing the estimated impacts compared with models without matching. We calculate the implied energy savings from the estimated premiums and find that, in the Research Triangle market, the Energy Star premiums approximately equal the savings that program is designed to achieve, but in Portland, the premiums are slightly greater than the program's savings due to low energy costs in the region.     

农作物病虫害专业化防治服务对农药施用强度的影响

农药过量施用已造成严重的负外部性。推行农作物病虫害专业化统防统治服务可以实现安全、科学、合理用药,有效缓解农业面源污染问题和提升食品的质量安全水平。为了探究病虫害专业化统防统治服务在缓解农业面源污染方面的效果,文章利用全国七省水稻病虫害专业化防治服务调查数据,基于倾向得分匹配方法(PSM),剔除样本自选择内生性问题的影响,分析农户将水稻病虫害防治环节外包给植保专业化服务组织("统防统治")与"自防自治"户相比使用农药的种类和施用次数的差异,即植保专业化防治是否取得了较好的环境效应。研究结果表明,植保专业化服务显著减少了农药施用强度,提高了无公害低毒农药的采用比例;并且其效果在小农户和规模种植大户之间存在明显差异,与采纳病虫害统防统治服务的规模种植大户相比,小规模种植户在采纳病虫害统防统治服务后在降低农药施用强度,提高无公害低毒农药的应用比例方面效果更显著。基于此,文章建议强化对植保专业化防治项目的财政扶持力度,提高病虫害专业化防治覆盖率;重点鼓励小规模种植户采纳病虫害统防统治服务;鼓励农户土地流转,促进农业生产规模化经营,加强对种植专业户的病虫害防治方面的培训和引导,并着力发挥专业大户的示范带头作用,提高统防统治的效率,从而促进食品质量安全水平的提升和农业生态环境的保护。     

Can climate mitigation help the poor? Measuring impacts of the CDM in rural China

This study examines whether investment in climate change mitigation contributes to poverty alleviation. We investigate the impacts of the renewable energy-based clean development mechanism (RE-CDM) projects on rural communities in China. The impacts of RE-CDM projects are estimated by combining propensity score matching with the difference-in-differences approach. We found that the biomass-based CDM projects significantly contribute to income improvement and employment generation in rural communities in China. Our estimation results also reveal that wind energy-based CDM projects have the potential to increase income and the share of labor force in the primary industry in rural areas. These results suggest different channels through which renewable energy sources affect income.     

A causal analysis of time-varying speed camera safety effects based on the propensity score method

Introduction: Speed limit enforcement cameras provide an effective approach to reduce vehicle speeds and the number of road accidents. However, it is still unclear whether the safety effects of speed cameras show durability over long periods of time. This paper analyses how the effects of speed cameras on road accidents change over time. A total number of 771 camera sites and 4787 potential control sites are observed for a period of 18 years (1999–2016) across England. Method: Covariates such as road class, crash history, speed limit, and annual average daily traffic (AADT) are included in the data set. A difference in difference (DID) based propensity score matching (PSM) method is employed to select proper control sites and estimate the treatment effects. The safety effects of speed cameras are then evaluated from a long-term perspective. The post-treatment period is divided into four equal-length periods: early, medium 1 and 2, and late. Results and Conclusions: The results show that speed cameras have significantly reduced the number of road accidents near the camera sites. However, the effects vary across different time periods. The safety effects of speed cameras experienced a sharp decrease during the medium periods after an initial period of highly reduced accidents (medium 1: −53.1%, medium 2: −40.7%) and recovered slightly during the late period. In addition, to evaluate the criteria for selecting camera sites in the UK, we further investigated whether speed cameras at high risk sites have better safety performance. The results show that while safety effects at high risk camera sites also decreased during the medium periods, the reduction was smaller (medium 1: −20.8%, medium 2: −2.1%). Practical Applications: Appropriate road traffic regulations and management, as well as proper camera sites selection criterion, are important to maintain the effectiveness of speed cameras.     

Rapid matching in Drosophila place learning

The level of conditioned behavior in animals is proportional to the intensity, amount, frequency, or probability of reinforcement. Interestingly, this matching can be dynamic, with performance levels following, for example, a switch in the probability of reinforcement with a short delay. We previously found that conditioned performance levels in Drosophila match reinforcement intensity in a place conditioning paradigm. Whether Drosophila can match conditioned behavior to a change in reinforcement intensity was an open question. In this study, we found that both conditioned behavior and memory levels match reinforcement intensity after a switch, and this rapid matching occurs within 2 min. Thus, fruit flies can dynamically match conditioned behavior and memory levels to a change in reinforcement intensity.     

中国碳交易试点政策对城市碳排放绩效的影响及机制

以2010~2016年中国273个地级市面板数据为样本,采用倾向得分匹配-双重差分方法（PSM-DID）检验了碳排放权交易政策对于城市碳排放强度的影响效果以及机制.研究发现：碳排放权交易政策对试点城市碳排放强度的降低具有显著而持续的推动作用,随着年份的推进,政策效果越发明显.此外,利用中介效应分析发现,通过调整产业结构和节能减排的途径可以有效降低城市的碳排放强度,而科研投入的影响尚不明确.基于此,本文建议应该进一步在全国范围推广碳排放权交易政策,优化产业结构,提高第三产业比重,推动企业节能减排并树立绿色低碳消费理念.     

安全管理体系的计算机辅助审核技术研究

关于海运公司安全管理体系 (SMS)的现行审核方法 ,难以保证其文件全面符合国际和国内的强制性规定 ,制约了《国际安全管理 (ISM)规则》效能的发挥。为此 ,课题组基于网络环境开发了对 SMS文件的计算机辅助审核技术 ,其主要成果包括 :建立了法规条款与 SMS文件的映射规则 ,使两者迅速匹配 ,以供审核 ;提出了 SMS文件符合法规程度的数学评价方法 ;设计了计算机辅助审核方案。经试审核 ,表明该技术能协助审核员迅速全面地发现 SMS文件对法规的不符合项 ,给出的符合程度定量合理 ,该技术有利于全面提高 SMS文件对法规条款的符合程度 ,从而方便了公司的全面履约。该技术还可用于类似的管理体系。     

建设机动车排放实验室若干问题探讨

建设一个良好的机动车排放实验室,规划与配套是关键。首先必须有一个良好的整体规划,其次应根据拟建实验室规模合理进行布局,重点应注意水电、标准气体、消防与通风设施、废气排放等方面合理配套。     

The contribution of traumatic brain injury to the medical and economic outcomes of motor vehicle-related injuries in Ohio

Objective

To describe traumatic brain injury (TBI) among injured roadway users. Aim 1 assessed the association of age, gender, alcohol/drug use, safety equipment use, type of roadway user, metropolitan area, and primary payer with motor vehicle-related TBI outcome. Aim 2 assessed the relationship of motor vehicle-related TBI and risk/protective factors with medical and economic outcomes.

Methods

Population-level hospital and trauma databases from the Ohio Hospital Association and Ohio Department of Public Safety, respectively, were probabilistically linked for 2003 through 2006. Injured roadway users (motor vehicle occupants, motorcyclists, bicyclists, pedestrians, and others) were assessed for TBI, ventilator use, intensive care unit (ICU) admission, injury severity score (ISS), need for rehabilitation, death, and total hospital charges.

Results

The odds of a motor vehicle-related TBI were greater among those not using safety equipment (OR = 1.56). The interactions of alcohol/drug use by gender and of alcohol/drug use by location were significant. Sustaining a TBI increased the odds of requiring ventilation (OR = 3.66), being admitted to the ICU (OR = 2.51), having a high ISS (OR = 4.24), requiring rehabilitation (OR = 2.22), or death (OR = 2.52). When compared with a non-TBI, total hospital charges increased by a factor of 1.35 for a TBI. Hospital charges were $46,441 on average for individuals who sustained a TBI, whereas mean hospital charges were $32,614 for patients with a non-TBI.

Conclusions

Among injured roadway users, individuals who sustain a TBI are more likely to require extensive medical care and have injuries resulting in death.

Impact on industry

Prevention strategies aimed at reducing alcohol use and increasing safety device use should be encouraged to reduce the burden of TBI.