Injured Persons Research Articles

Mechanical Injury among Medicolegal Cases in the Department of Emergency in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

A medico-legal issue arises whenever an injured person visits a hospital. Therefore, all physicians who treat such patients have a legal duty to accurately document injuries as part of medical treatment. The study aimed to find out the prevalence of mechanical injury among medicolegal cases in the Department of Emergency in a tertiary care centre. A descriptive cross-sectional study was conducted among patients admitted to the Emergency Department of a tertiary centre from May 2018 to April 2020 after obtaining ethical approval from the Institutional Review Committee (Reference number: 356). Convenience sampling method was used among patients who met the eligibility criteria. All relevant data were extracted using hospital records. Point estimate and 95% Confidence Interval were calculated. Out of 3486 medicolegal cases registered in the Department of Emergency, 856 (24.55%) (28.37-29.96 at 95% Confidence interval) were cases of mechanical injuries. Males 616 (71.96%) outnumbered females for all types of mechanical injuries. Road Traffic Accident 527 (61.56%) was the leading cause of injury and lacerations 351 (29.52%) were the most common pattern of injury. The majority 628 (73.36%) of the injuries were simple in nature. The prevalence of mechanical injuries among medicolegal cases was similar in our study compared to other studies done in similar settings. The majority of the injuries were caused by traffic accidents, which could have been prevented if a safe system approach to road safety was followed. accidents; documentation; forensic medicine; injuries; Nepal.

Evaluation of Color Anomaly Detection in Multispectral Images for Synthetic Aperture Sensing

In this article, we evaluate unsupervised anomaly detection methods in multispectral images obtained with a wavelength-independent synthetic aperture sensing technique called Airborne Optical Sectioning (AOS). With a focus on search and rescue missions that apply drones to locate missing or injured persons in dense forest and require real-time operation, we evaluate the runtime vs. quality of these methods. Furthermore, we show that color anomaly detection methods that normally operate in the visual range always benefit from an additional far infrared (thermal) channel. We also show that, even without additional thermal bands, the choice of color space in the visual range already has an impact on the detection results. Color spaces such as HSV and HLS have the potential to outperform the widely used RGB color space, especially when color anomaly detection is used for forest-like environments.

Spatiotemporal distribution patterns of deadly geohazard events in China, 2013–2019

This study collected and compiled the deadly geohazard events that occurred in China during 2013–2019, and counted 779 deadly geohazard events, resulting in 2386 dead and missing persons (387 missings), 670 injured persons, and the number of people affected by the hazards reached 187,893, with an economic loss of about 534 million USD. We selected the number of events, the number of deaths and missing persons, the number of affected persons and economic losses as indicators, and analyzed the spatial and temporal distribution patterns of disaster events, and further discussed the characteristics of hazard types and triggering factors. The statistical units include annual scale, month scale, province/municipality and geographical region. The statistical results show that the number of deadly geohazard events showed a decreasing trend on the annual scale, and the casualties and losses caused rebounded. The high incidence of deadly geohazard events is concentrated from June to August. Deadly geohazard events are most frequent in southern and southwestern China and are most severe in terms of the number of deaths and missing persons. The same pattern applies to the analysis of provinces/municipalities. The most frequent types of geohazards are landslides and rockfalls, debris flows caused the highest number of people affected. Most of the event triggers are natural factors, and among them, the rainfall factor is the most dominant trigger. Precipitation shows a significant positive correlation with the number of deadly geohazard events on the monthly scale.

Clinic–anatomical characteristic of the traffic–transport trauma in the megapolis environment First communication: the damage volume

Objective. To determine the damage volume as a significant component of clinical–anatomical characteristic of traumas in the injured persons, who have obtained the trauma as a consequence of the traffic–transport accidents in the megapolis environment.
 Materials and methods. Retrospective analysis of data, concerning 1139 injured persons, who have got trauma as a consequence of the traffic–transport accidents in the City of Kyiv in the period 2019–2020 yrs.
 Results. There was established, that up to 70% of the injured persons have got a small volume of damage – with injuries of up to three anatomic–functional sites. Only 9% of such injured persons have got a big volume of trauma. The trauma volume have impacted the result of the traumatic process course with the discovered tendency for enhancement of part of the injured persons, obtaining negative result as a consequence of the trauma volume enhancement.
 Conclusion. Among the traumas, which were got by the injured persons as a consequence of the traffic–transport accidents in the megapolis environment, the restricted by volume trauma prevails – up to 75.42%. Injuries of four anatomic–functional sites as a consequence of the traffic–transport accidents constitute a critical volume of the damage obtained for these category of injured persons. The damage volume in the injured persons, who were traumatized due to the traffic–transport accidents depends immediately upon such factor as «the taking part in the injured person movement», while the biggest influence have demonstrated the factor of «taking part in the pedestrian movement». The factor, named as a «taking part in movement of the injured person» impacts immediately the result of the traumatic process course in any volume of the damage, and this influence is enhancing with the damage volume enhanced.

METHODOLOGICAL APPROACH TO DETERMINATION OF EVACUATION BASIC PARAMETERS OF INJURED PERSONNEL OF OPERATIONAL GROUPING OF TROOPS USING DIFFERENT MEANS OF TRANSPORT

The timing of the evacuation of the wounded is a critical factor that largely determines the fate of the injured soldier. At present, despite considerable efforts to provide the Armed Forces of Ukraine with weapons and military equipment as well as logistical support, including medical equipment and assets, in particular basing as well on international technical aid, the problem of the absence of the required number of specialized medical evacuation means has not been resolved.
 From this point of view, the question of the correct formation of requirements for rational composition and specially equipped various types of vehicles (including sanitary transporters, ambulances), also general use, casualty evacuation systems, Identifying the possibility of its further improvement through the methodological apparatus is topical.
 The existing system of military evacuation of the injured and ill people is a four level system where all critically and moderately injured are evacuated. Regarding this, the evacuation system of the injured persons might be considered as queuing network, which has a range of peculiarities. First of all this network of queuing is an open network of queuing service, in other words the flow of applications for the network input is unlimited, homogeneous and is carried out from an external independent source. As a result of the calculations the data were received on the figures of network parameters (average number of requests in queues, average number of requests in the network, average waiting time for requests in service queues, average time of request in the network) and parameters of each queuing system which is operating in the network queuing, – transmission ratio, input flow intensity, downloading ratio, average number of occupied channels, average number of requests in the queuing system, average queue length, average waiting time of the request in the queue for being served, the average time of the request in the queuing system. Analyzing the calculated data from the point of view of creating a rational open queuing network, the system of the injured persons evacuation reaches its maximum efficiency when its productivity on processing the incoming flow of the requests is on its maximum level, and such parameters as the number of service requests in the queue and the number of service channels operating in the network are on its minimum level.

ПРОБЛЕМЫ ПРАКТИЧЕСКОГО ПРИМЕНЕНИЯ КРИТЕРИЕВ ОПРЕДЕЛЕНИЯ СТЕПЕНИ УТРАТЫ ПРОФЕССИОНАЛЬНОЙ ТРУДОСПОСОБНОСТИ ПОСТРАДАВШИХ НА ПРОИЗВОДСТВЕ

In 2018, the UN Committee on the Rights of Persons with Disabilities recommended the Russian Federation to amend the rules for establishing the degree of loss of professional ability to work in order to increase the level of transparency and efficiency of guarantees provided to workers injured as a result of accidents and occupational diseases.
 Objective: to assess the need to amend the existing Temporary criteria for determining the degree of UPT based on an analysis of established expert practice in various constituent entities of the Russian Federation and other factors that can affect the severity of the consequences of work-related injuries and occupational diseases. To assess the existing practice of establishing the degree of loss of professional ability to work, expert decisions were analyzed in 77 constituent entities of the Russian Federation over the past 3 years, existing regulatory legal documents, indicators of the quality and accessibility of medical care in the constituent entities of the Russian Federation, as well as data on the duration of cases of temporary disability in injured persons at work . The analysis revealed a high level of variability of expert decisions made and the absence of a relationship between the quality and availability of medical care in the constituent entities of the Russian Federation and the length of time on the sick leave for the consequences of injuries at work. Given the high level of variability of expert decision making in the constituent entities of the Russian Federation for similar expert cases (coefficient of variation of 21.6%), the authors conclude that it is necessary to change approaches to the methodology for assessing the nature of professional activity (qualifications, quality and volume of work, ability to perform it) .

Assessment of standard HIV testing services delivery to injured persons seeking emergency care in Nairobi, Kenya: A prospective observational study.

Emergency departments (EDs) in Africa are contact points for key groups for HIV testing services (HTS) but understanding of ED-testing delivery is limited which may impeded program impacts. This study evaluated the offering and uptake of standard HTS among injured persons seeking ED care at Kenyatta National Hospital (KNH) in Nairobi, Kenya. An ED population of adult injured persons was prospectively enrolled (1 March-25 May 2021) and followed through ED disposition. Participants requiring admission were followed through hospital discharge and willing participants were contacted at 28-days for follow up. Data on population characteristics and HTS were collected by personnel distinct from clinicians responsible for standard HTS. Descriptive analyses were performed and prevalence values with 95% confidence intervals (CI) were calculated for HIV parameters. The study enrolled 646 participants. The median age was 29 years with the majority male (87.8%). Most ED patients were discharged (58.9%). A prior HIV diagnosis was reported by 2.3% of participants and 52.7% reported their last testing as >6 months prior. Standard ED-HTS were offered to 49 or 8.6% of participants (95% CI: 5.8-9.9%), among which 89.8% accepted. For ED-tested participants 11.4% were newly diagnosed with HIV (95% CI: 5.0-24.0%). Among 243 participants admitted, testing was offered to 6.2% (95% CI: 3.9-9.9%), with 93.8% accepting. For admitted participants tested 13.3% (95% CI: 4.0-35.1%) were newly diagnosed (all distinct from ED cases). At 28-day follow up an additional 22 participants reported completing testing since ED visitation, with three newly diagnosed. During the full follow-up period the HIV prevalence in the population tested was 10.3% (95% CI: 5.3-19.0%); all being previously undiagnosed. Offering of standard HTS was infrequent, however, when offered, uptake and identification of new HIV diagnoses were high. These data suggest that opportunities exist to improve ED-HTS which could enhance identification of undiagnosed HIV.

Ambulance detection for smart traffic light applications with fuzzy controller

<p>In the development of intelligent cities, the automation of vehicular mobility is one of the strong points of research, where intelligent traffic lights stand out. It is essential in this field to prioritize emergency vehicles that can help save lives, where every second counts in favor of the transfer of a patient or injured person. This paper presents an artificial intelligence algorithm based on two stages, one is the recognition of emergency vehicles through a ResNet-50 and the other is a fuzzy inference system for timing control of a traffic light, both lead to an intelligent traffic light. An application of traffic light vehicular flow control for automatic preemption when detecting emergency vehicles, specifically ambulances, is oriented. The training parameters of the network, which achieves 100% accuracy with confidence levels between 65% with vehicle occlusion and 99% in direct view, are presented. The traffic light cycles are able to extend the green time of the traffic light with almost 50% in favor of the road that must yield the priority, in relation to not using the fuzzy inference system.</p>

Cross-sectional study of gender differences in physical activity-related injuries amongst Chinese college students majoring in rehabilitation.

The main objective of the paper was to explore the potential risk factors for physical activity-related injuries (PARI) amongst college students majoring in rehabilitation and to analyse gender differences. A random whole group sampling method was used to recruit freshmen to seniors aged 15–25 years from over 90 universities in China that offer rehabilitation. The total number of people included was 6,032, of which 1,989 were male and 4,043 were female. The underlying risk factors for PARI of different genders were assessed using a structured self-management questionnaire including sociodemographic characteristics, physical activity levels, risk-taking and protective behaviors, and PARI. Totally 6,032 questionnaires were obtained for final analysis, with 792 total number of injured persons (415 males, 377 females), the sum of the cumulative frequency of injuries to injured persons is 1,607 (881 males, 726 females) and a PARI risk of 0.27 (males: 0.44, females: 0.18; p < 0.001; sum of the cumulative frequency of injuries/total number of people surveyed/year). For male and female students, participation in sports teams, having a high level of PA as well as with antisocial behavior were risk factors for developing PARI. Regarding female students, regional differences was associated with elevated odds to suffer from PARI. The prevalence rates of PARI vary between male and female students. The research subjects were university students in rehabilitation. Compared to general college students, rehabilitation students have a certain knowledge base related to injuries, which defines the specificity and research value of this subjects. This study provides guidance for reducing PARI in students in rehabilitation and may provide a basis for developing future injury prevention mechanisms for university students in general.

An extended model for crowd evacuation considering rescue behavior

Most evacuation processes require the presence of people outside the scene, such as firefighters, to assist the trapped individuals to evacuate. This paper establishes an extended model for crowd evacuation considering rescue behavior. In the model, rescuers enter from the exit, approach the hazard source, and search for the injured individual. According to the physical condition of the injured pedestrian, there are two rescue methods: supporting or carrying the injured persons on their backs. Persons trapped in a room are evacuated by walking or crawling depending on their health condition, and healthy persons will rescue the surrounding crawling and evacuated individuals with a certain probability. Simulation results demonstrate that during the evacuation process considering rescue behavior: (1) The presence of rescuers improves evacuation efficiency. When the number of rescuers exceeds a certain threshold, the efficiency of evacuation will begin to decline. However, the evacuation efficiency with rescuers is still better than when there are no rescuers. (2) Increasing the possibility of pedestrian mutual assistance can improve evacuation efficiency. However, the effect of pedestrian mutual assistance probability on evacuation has a critical value. (3) The greater the distance from the hazard source to the exits, the smaller is the effect of the hazard source on evacuation. (4) when the total width of all exits is the same, the evacuation efficiency of two exits is higher than that of a single exit. The model and overall simulation results can help to develop different evacuation strategies and improve search and rescue plans according to specific scenes.

Experiences of spinal cord injury patients admitted to the rehabilitation unit at the national referral hospital in Khomas region, Namibia.

BackgroundSpinal cord injury (SCI) remains one of the major causes of disability globally. It results in permanent physical disability secondary to devastating neurological defects. When a person sustains SCI, substantial changes and challenges in their lives occur, regardless of their age or socioeconomic status. In Namibia, the knowledge on SCI experiences could be used to improve the care rendered to patients with this injury.ObjectivesThe purpose of this study was to explore and describe the experiences of patients with SCIs admitted to the rehabilitation unit at the national referral hospital in Khomas region, Namibia.MethodA qualitative, explorative and descriptive study design was used. Data were collected by means of in-depth, semi-structured, face-to-face interviews with 15 participants from the rehabilitation unit. Data were analyzed using thematic analysis.ResultsAnalysis of the data in this study identified three themes: negative experiences, positive experiences and measures to improve the lives of people living with SCI in the community. Participants experienced varied emotions from anger, stress, disbelief, frustration and sadness, which led to depression. In addition, participants experienced discrimination due to lack of community acceptance hence, improving awareness remains key.ConclusionThis study provided insight into the lived experiences of those living with SCI as they narrated their struggle from the onset of SCI to their reintegration into the community. The study’s findings can be used to develop self-care strategies and ongoing interventions that focus on maintaining physical and psychological health for spinal-cord injured persons throughout the course of living with disability.

Assessment of substance use among injured persons seeking emergency care in Nairobi, Kenya.

IntroductionTrauma is a leading cause of morbidity and mortality in Kenya. In many countries, substance use is common among patients presenting with injuries to an emergency center (EC).ObjectiveTo describe the epidemiology of self-reported substance use among adult injured patients seeking ED care in Nairobi, Kenya.MethodsThis prospective cross-sectional study, assessed patients presenting with injuries to the Kenyatta National Hospital ED in Nairobi, Kenya from March through June of 2021. Data on substance use, injury characteristics and ED disposition were collected. Substances of interest were alcohol, stimulants, marijuana, and opiates. The Alcohol Use Disorders Identification Test-Concise (AUDIT-C) tool was used to characterize hazardous alcohol use.ResultsA total of 1,282 patients were screened for participation, of which 646 were enrolled. Among participants, 322 (49.8%) reported substance use in the past month (AUDIT-C positive, stimulants, opiates, and/or marijuana). Hazardous alcohol use was reported by 271 (42.0%) patients who screened positive with AUDIT-C. Polysubstance use, (≥2 substances) was reported by 87 participants in the past month. Median time from injury to ED arrival was 13.1 h for all enrolees, and this number was significantly higher among substance users (median 15.4 h, IQR 5.5 - 25.5; p = 0.029).ConclusionsIn the population studied, reported substance use was common with a substantial proportion of injured persons screening positive for hazardous alcohol use. Those with substance use had later presentations for injury care. These data suggest that ED programming for substance use disorder screening and care linkage could be impactful in the study setting.

Evaluation of Exclusive Pedestrian Phase Safety Performance at One-Level Signalized Intersections in Vilnius

This work aims to identify the effectiveness of one-level signalized intersections with exclusive pedestrian phases in terms of vehicle-pedestrian crashes resulting in pedestrian injury or fatality. The work analyzes and evaluates specific exclusive pedestrian phases without diagonal crossing possibility at one-level signalized intersections in the city of Vilnius. Anonymized data on traffic accidents from the Lithuanian Police Department Accident Register were used for safety analysis purposes. The traffic accident data cover all traffic accidents with dead or injured persons. The traffic accident data was analyzed with the help of QGIS for selected time intervals (before and after analysis). The density of traffic accidents was calculated with the help of the comparative analysis method at 11 signalized intersections in Vilnius City, where an exclusive pedestrian phase without diagonal crossing was implemented. An exclusive pedestrian phase with diagonal crossing is usually implemented to increase pedestrian safety at a signalized intersection with a high pedestrian intensity. The analysis carried out indicates that the specific exclusive pedestrian phase without diagonal crossings in Vilnius reduced pedestrian traffic accidents by up to 100%. No traffic accidents occurred after the installation of the exclusive pedestrian phase at intersections where there were no pedestrian accidents prior to the installation.

Laws relating to trade mark infringement in India

The brand label is one of the framework benefits. Authorized creativity rights allow persons to retain ownership of their original goods and creative activity. Because classified invention became known via the capacity of people labor, it is limited by different enrolling and despotism fees. There are several types of intellectual property such as Trademarks, Copyright Act, Patent Act, and Designs Act. A brand is a label, phrase, or symbol that distinguishes an item from those of other firms. The system's promotion of labor and goods is more simpler with a name, since the item's identification with the label is assured and easy. The owner is entitled to restrict other participant from using his or her trademark or symbol.The law of unfair commerce has often served as a guiding principle in conflict resolution. The main technique was the general public's desire not to be duped. Furthermore, the benefit to the injured person of not receiving their compensation for all their mistreated work and effort should not be overlooked. Nevertheless, there is also the method of strengthening competitiveness for the welfare of the majority. Trademark law is based on solutions to property rights, financial expediency, buyer trust, and broad concepts of justice.

Exploring the perspectives of key stakeholders in returning to work after minor to serious road traffic injuries: a qualitative study.

This qualitative study conducted in Queensland, Australia aimed to explore various stakeholders' perspectives on (1) the barriers and facilitators of Return to Work (RTW) for injured persons following minor to serious Road Traffic Injuries (RTI) in a fault-based scheme, and to investigate the changes needed to better support RTW following RTI. The study was performed using the Interpretive Description methodological approach. Data were collected during interviews (n = 17), one focus group (n = 4), and an open-ended survey (n = 10) with five categories of stakeholders: treating health providers, workplace representatives, legal representatives, rehabilitation advisors, and insurers. Participants were eligible to participate if they had at least one year of employment history in their respective profession in Queensland, Australia, and were experienced in assisting the RTW of people with RTI. Thematic analysis was used to analyse the data. Seven themes were extracted reflecting the barriers and facilitators of RTW along with stakeholders' recommendations to address these barriers. These themes were: (1) knowledge is power; (2) stakeholder expertise; (3) early and appropriate treatment matters; (4) insurers could do better; (5) necessity of employers' support; (6) fix the disjointed system; (7) importance of individual factors pre- and post- injury. The main barriers identified were stakeholders' insufficient communication and knowledge on RTW process following RTI. Individual and system barriers identified in this study suggest that RTW after RTI occurs in a complex system requiring the commitment of all stakeholders. This is particularly important for managing knowledge-related barriers by provision of high quality and easily accessible information about the RTW process, disability schemes, and the nature of RTI.

중대재해처벌법 대응을 위한 건설현장 안전보건관리체계 범위에 관한 연구

A serious accident refers to an industrial accident in which the severity of the accident, such as death, is severe, or in which a large number of injured persons occur. According to the Occupational Safety and Health Act, a serious accident is defined as an accident in which one or more fatalities, two or more injured persons requiring treatment for 3 months or longer, or ten or more injured or occupational diseases occur simultaneously. The reason that the law distinguishes major disasters from general disasters and stipulates separate treatment procedures is to prevent recurrence of such disasters in the future in consideration of the severity of the damage. It should be understood that the Major Accident Punishment Act, which recently strengthened the responsibility of business owners and business managers for the occurrence of serious accidents, is for the prevention and recurrence of serious accidents rather than punishment for those responsible. As the Serious Accident Punishment Act came into effect on January 27, 2022, business owners and managers of businesses or workplaces that are actually controlled, operated, and managed have the duty to secure safety and health for workers. Here, the obligation to secure safety and health means to prevent serious industrial accidents by strengthening safety and health measures through the establishment of a safety and health management system. However, in the Serious Disaster Punishment Act, the specific scope and action plan for each project for the establishment of a safety and health management system are not presented, so preparations for and response to the enforcement of the law are insufficient. Therefore, the establishment of a safety and health management system (hereinafter referred to as the “safety and health management system”) at the workplace where a serious accident occurs is the key, and how to effectively and specifically establish and operate it is an important factor. However, in order to establish an effective and specific safety and health management system through the Serious Disaster Punishment Act and related instructions, it is difficult to respond to the law because the scope and direction of the safety and health management system are insufficient. In this study, for one month from November 18th to December 17th, 2021, 7 construction sites were inspected through three institutions: a health and safety diagnosis institution (Article 48 of the Industrial Safety and Health Act) and a construction accident prevention expert guidance institution. For a total of 12 sites including 5 civil engineering sites, 13 items were checked on the fulfillment of obligations in accordance with safety and health laws Therefore, this study draws on the scope of the safety and health management system at construction sites required by the Serious Disaster Punishment Act and the direction of effective system construction.

Development of First Aid Self-learning Web Application for Road Accident Victims

BACKGROUND: Knowledge of prehospital scene care for injured person in road accidents is essential for improving outcome and saving lives of traffic accident victims. However, the situation of the COVID-19 pandemic may cause people’s inability to access in-person first aid training. AIM: This study aimed to determine the effect of first aid self-learning web application for road accident victims on the knowledge and satisfaction of the web application users. METHODS: A prospective, single-arm, and educational cohort study was conducted among second-year physical education participants at Khon Kaen University attending first aid self-learning web application for road accident victims in July 2021. All participants were attended ten lessons covering important content of first aid for an injured person in road accidents. Each lesson includes reading texts, 3-min animation videos, and pre-test and post-test. Data analysis includes a comparison of the pre-test and post-test knowledge scores using the paired t-test. The participant’s satisfaction was analyzed using descriptive statistics. RESULTS: The 42 participants were participated in this study. Sixty-two percent of the participants had no previous first aid experience for an injured person in road accidents. The mean pre-test and post-test scores were 25.31 ± 3.87 and 27.50 ± 2.91, respectively. There was a significant difference between the pre-test and the post-test scores (p &lt; 0.001). The participant’s level of satisfaction score was very good (4.25 ± 0.95). CONCLUSIONS: The first aid self-learning web application significantly improved the first aid knowledge of the web application users. Moreover, most participants reported good level of satisfaction for using this tool. This emphasized that the first aid self-learning web application was the great tool in COVID-19 learning.

Trip, Slip and Fall: ICD10 and Fall from Height

Background: ICD 10 has unified the diagnosis, in this study, we have studied fall from height asper ICD 10 classification of cases who reported to emergency department of tertiary care hospitalin Maharashtra. Unintentional fall from height represents a significant cause of injury in urbanpopulations.Results: In this retrospective study, data pertaining to cases which were examined and treated ata tertiary care centre in Western India was analysed from 2014-2016. A total of 44 cases qualifiedour criteria of unintentional fall from height.83% of the population study were male. 21-40 yearsof age were most commonly affected. Alcohol was a common factor amongst the falls. As the yearprogressed number of cases have decreased. W10 ICD 10, fall from stairs were the most commoncause of fall. Head injuries (42%) followed by extremities injuries were the most common.Conclusion: A significant number of non – fatal cases occur due to unintentional fall from height.There is a need to study the demographic profile of injured persons, assess the severity of theirinjuries and identify certain risk factors associated with such non-fatal injuries due to fall fromheight.

Community Opioid Dispensing After Injury (CODI): Protocol for a Population-Based Data Linkage Study

BackgroundThere is an urgent need to reduce preventable deaths and hospitalizations from prescription opioid harms and minimize the negative effect opioid misuse can have on injured individuals, families, and the wider community. Data linkage between administrative hospitalization records for injured patients and community opioid dispensing can improve our understanding of the health and surgical trajectories of injured persons and generate insights into corresponding opioid dispensing patterns.ObjectiveThe Community Opioid Dispensing after Injury (CODI) study aims to link inpatient hospitalization data with opioid dispensing data to examine the distribution and predictive factors associated with high or prolonged community opioid dispensing among adults, for 2 years following an injury-related hospital admission.MethodsThis is a retrospective population-based cohort study of adults aged 18 years or older hospitalized with an injury in Queensland, Australia. The study involves the linkage of statewide hospital admissions, opioid prescription dispensing, and mortality data collections. All adults hospitalized for an injury between January 1, 2014, and December 31, 2015, will be included in the cohort. Demographics and injury factors are recorded at the time of the injury admission. Opioid dispensing data will be linked and extracted for 3 months prior to the injury admission date to 2 years after the injury separation date (last date December 31, 2017). Deaths data will be extracted for the 2-year follow-up period. The primary outcome measure will be opioid dispensing (frequency and quantity) in the 2 years following the injury admission. Patterns and factors associated with community opioid dispensing will be examined for different injury types, mechanisms, and population subgroups. Appropriate descriptive statistics will be used to describe the cohort. Regression models will be used to examine factors predictive of levels and duration of opioid use. Nonparametric methods will be applied when the data are not normally distributed.ResultsThe project is funded by the Royal Brisbane and Women’s Hospital Foundation. As of November 2021, all ethics and data custodian approvals have been granted. Data extraction and linkage has been completed. Data management and analysis is underway with results relating to an analysis for blunt chest trauma patients expected to be published in 2022.ConclusionsLittle is currently known of the true prevalence or patterns of opioid dispensing following injury across Queensland. This study will provide new insights about factors associated with high and long-term opioid dispensing at a population level. This information is essential to inform targeted public policy and interventions to reduce the risk of prolonged opioid use and dependence for those injured. The novel work undertaken for this project will be vital to planning, delivering, monitoring, and evaluating health care services for those injured. The findings of this study will be used to inform key stakeholders as well as clinicians and pain management services.International Registered Report Identifier (IRRID)RR1-10.2196/36357

IMPACT OF THE NUMBER OF VEHICLES ON TRAFFIC SAFETY: MULTIPHASE MODELING

Traffic safety is one of the key issues nowadays, given the fact that a large number of people lose their lives in traffic accidents every day. There are various influential factors in the occurrence of traffic accidents, the number of vehicles being one of them. This paper assesses the traffic safety in Montenegro in the period 1998-2020 by applying the multiphase modeling with a purpose to obtain comparative results which enable implementation of adequate strategies. A total of six scenarios were formed with two inputs and two outputs in a DEA (Data Envelopment Analysis) model, with the number of registered vehicles per year being an input in all scenarios. In addition, as inputs, the scenarios included AADT (Annual Average Daily Traffic), passengers in road transport, passenger-km by road transport, goods transported by road, tone-km by road, and passengers in local transport. The number of traffic accidents with casualties, the number of traffic accidents with material damage, the number of fatal cases and the number of injured persons, depending on a scenario, were observed as outputs. After the DEA model, IMF SWARA (Improved Fuzzy Stepwise Weight Assessment Ratio Analysis) was applied to determine the weights of inputs and outputs, while the final state of traffic safety by years was determined using the MARCOS (Measurement of alternatives and ranking according to COmpromise solution) method.