Pre-law Period Research Articles

The immediate impact of mandatory helmet law on maxillo-facial trauma: A comparative study in a major trauma center, Uttar Pradesh.

To analyze the effect of the mandatory helmet rule in helmet usage among motorcycle riders and on facial trauma and to determine the significance of difference in the possibility of facial trauma between the helmeted and non-helmeted motorcycle riders. A retrospective comparative study conducted in a major trauma center at Uttar Pradesh. Data for the present study was obtained from records of the Emergency Department of Trauma Center, for a period of two months before and after the implementation of The Motor Vehicles Act in UP. The study included patients with a history of non-fatal motorcycle accidents who sustained facial injuries regardless of the presence of injuries to other areas of the body during the study period. Information regarding helmet usage during the accident was also recorded. The results were compared between the pre-law period and post-law period. Sample t-test was applied to find the level of significance. Out of 219 injured patients, 152 (69.40%) subjects were not wearing helmets, whereas only 67 (30.59%) subjects were wearing helmets. It was observed that around 68.18% of people stated wearing helmets after law implementation with a statistical significance (P value < 0.05). Our study shows that the mandatory helmet rule with elevated penalty rates has significantly increased the usage of helmet among the motorcycle riders, and it also proves that the possibility of facial trauma is significantly higher in non-helmeted riders when compared to helmeted riders.

Impact of National Tobacco Control Policy on Rates of Hospital Admission for Pneumonia: When Compliance Matters.

A number of studies claim that tobacco control (TC) regulations are associated with reductions in smoking-related hospitalisation rates, but very few have estimated the impact of TC laws (TCL) at both countrywide and regional levels, and none of them have studied the impact of TCL in relation to compliance with TC regulations. This study evaluates the effects of Russian TCL on hospital admission (HA) rates for pneumonia countrywide and in 10 Russian regions and the extent of these effects in connection with the compliance with TCL. Methods: HA rates for pneumonia from 2005-2019 were analysed to compare the periods before and after the adoption of TCL in 2013. An interrupted time series design and a Poisson regression model were used to estimate the immediate and long-term effects of TCL on pneumonia annual hospitalisation rates after the TCL adoption, compared with the pre-law period. The 10 Russian regions were compared using the TCL implementation scale (TCIS) developed on the basis of the results of the Russian TC policy evaluation survey; Spearman's rank correlation and linear regression models were employed. Results showed a 14.3% reduction in HA rates for pneumonia (RR 0.88; p = 0.01) after the adoption of TCL in Russia with significant long-term effect after 2013 (RR 0.86; p = 0.006). Regions with better enforcement of TCL exhibited greater reductions in pneumonia HA rates (rsp = -0.55; p = 0.04); (β = -4.21; p = 0.02). Conclusions: TCL resulted in a sustained reduction in pneumonia hospitalisation rates, but these effects, varying by region, may depend on the scale of the TCL enforcement.

Medical Marijuana Legalization in Oklahoma: Effects on Neonatal Exposure to Opiates.

The U.S. opioid epidemic has been characterized by increases in opioid misuse, overdose deaths, and neonatal opioid withdrawal syndrome. Research suggests that marijuana legalization has contributed to decreased use of opiates, although many studies had methodological weaknesses and failed to address the pregnant population. Implementation of medical cannabis laws has the potential to reduce maternal opioid use and, therefore, neonatal exposure to the drugs. This study aimed to examine the association between Oklahoma's implementation of state medical marijuana laws and the neonatal exposure to opioids. Electronic medical records at two sites (Oklahoma City and Lawton) were searched for results of cord, urine, and meconium screens to detect amphetamines, barbiturates, benzodiazepines, cocaine, ethanol, opiates, phencyclidine, and tetrahydrocannabinol (THC). Two study periods were compared: 19 months before Oklahoma's medical marijuana law took effect and 19 months after legalization began. A total of 16,804 babies were born alive at the two sites during the study period. The rate of positive THC tests per 1,000 liveborn infants significantly increased from 16.2 per 1,000 during the prelaw period to 22.2 per 1,000 during the postlaw period (p = 0.004). Neonatal opioid exposure incidence showed a nonsignificant decrease from 7.6 positive tests per 1,000 liveborn infants to 6.8 per 1,000 from prelaw to postlaw period (p = 0.542). The number of positive tests for THC and concomitant use of opioids doubled from the prelaw period (n = 4) to postlaw (n = 9), but there were too few cases for statistical significance. Infants at the more rural site had significantly higher rates for amphetamines, benzodiazepines, and THC, with a trend toward higher rates for opiates. Marijuana legalization was related to significant increases in positive test rates for THC, but no significant change/association was noted for neonatal exposure to opioids. · Prior studies have not examined neonatal exposure to opioids following marijuana legalization.. · Oklahoma's new law led to higher neonatal marijuana exposure.. · Legalization of medical marijuana did not change Oklahoma's neonatal opioid positivity rate..

Change in adverse event reporting following immunization of hepatitis B vaccine among infants between 2013 to 2020 before and after the vaccine administration law in China.

BackgroundHepatitis B vaccine (HepB) has been routinely recommended as part of the immunization program in China and has had a satisfactory safety and effectiveness profile in protecting infants from hepatitis B virus infection. We evaluated the surveillance sensitivity and changes over time of AEFI reports related to HepB among infants based on the consistent national data before and after the introduction of vaccine administration law (LAW) from 2013 to 2020 in China.MethodsAEFI records were extracted from the Chinese National AEFI Surveillance System from 2013 to 2020. According to the proportion of different kinds of HepB vaccines distributed, the annual administration data of the most distributed HepB produced by Bio-Kangtai and its corresponding adverse reaction reports were collected and analyzed. We categorized the time interval into the pre-LAW period (2013 to 2017), transition period (2018 to 2019), and LAW period (2020) to demonstrate the impact of LAW on the surveillance patterns of AEFIs.ResultsThe annual AEFI rates increased from 3.1/100,000 to 14.8/100,000 over this period in total. The rate ratio for the post-LAW period and pre-LAW period was 2.19 (95%CI: 2.10, 2.29). Common reactions occupied 87.6% of the total reported AEFIs whose rate was recorded as 7.9/100,000. Rare reactions occupied 9.1% of the total AEFIs showing an average rate of 0.8/100,000, of which anaphylaxis accounted for over 80%, with the rate ratio of the transition period and LAW period as 1.36 (95%CI:1.22, 1.52) and 1.14 (95%CI:0.95, 1.35), respectively. Children receiving more than one vaccine showed a higher proportion of fever, anaphylaxis, and febrile convulsions, which were suggested to be a result of vaccine co-administration vaccines, such as the DPT and Polio vaccine.ConclusionMost reactions were mild and self-limited and the rates of rare more serious events remained stable. The LAW has largely increased the surveillance capability and sensitivity on AEFIs of HepB and also contributes to enhancing public confidence in HepB immunization. Hepatitis B vaccination is a safe and effective means of preventing the complications of hepatitis B disease and continuous standardized AEFI investigation and assessment of causal association should be maintained.

Effects of state opioid prescribing cap laws on opioid prescribing after surgery.

To evaluate the effects of state opioid prescribing cap laws on opioid prescribing after surgery. OptumLabs Data Warehouse administrative claims data covering all 50 states from July 2012 through June 2019. We included individuals from 20 states that had implemented prescribing cap laws without exemptions for postsurgical pain by June 2019 and individuals from 16 control states plus the District of Columbia. We used a difference-in-differences approach accounting for differential timing in law implementation across states to estimate the effects of state prescribing cap laws on postsurgical prescribing of opioids. Outcome measures included filling an opioid prescription within 30 days after surgery; filling opioid prescriptions of specific doses or durations; and the number, days' supply, daily dose, and pill quantity of opioid prescriptions. To assess the validity of the parallel counterfactual trends assumption, we examined differences in outcome trends between law-implementing and control states in the years preceding law implementation using an equivalence testing framework. We included the first surgery in the study period for opioid-naïve individuals undergoing one of eight common surgical procedures. State prescribing cap laws were associated with 0.109 lower days' supply of postsurgical opioids on the log scale (95% Confidence Interval [CI]: -0.139, -0.080) but were not associated with the number (Average treatment effect on the treated [ATT]: -0.011; 95% CI: -0.043, 0.021) or daily dose of postsurgical opioid prescriptions (ATT: -0.013; 95% CI: -0.030, 0.005). The negative association observed between prescribing cap laws and the probability of filling a postsurgical opioid prescription (ATT: -0.041; 95% CI: -0.054, -0.028) was likely spurious, given differences between law-implementing and control states in the pre-law period. Prescribing cap laws appear to have minimal effects on postsurgical opioid prescribing.

Decrease in injuries from fireworks in Hawaii: associations with a county policy to limit access

ObjectiveTo examine trends in fireworks-related injuries (FRI) before and after enactment of an ordinance to limit access in the City and County of Honolulu (the island of Oahu).MethodsSurveillance of FRI...

Analyzing the impact of a state concussion law using an autoregressive integrated moving average intervention analysis

BackgroundExisting studies analyzing the impact of state concussion laws have found an increase in concussion-related medical encounters post-law, in some instances, such increases were observed during the pre-law period due to a potential “spillover” effect. This study assessed the effects of Ohio’s concussion law, while accounting for such a “spillover” effect, on the trends in monthly rates of concussion-related medical encounters in Medicaid insured children using autoregressive integrated moving average (ARIMA) analysis.MethodsWe analyzed claim data obtained from the Partners For Kids database, a pediatric accountable care organization in Ohio. Concussion-related medical encounters for Medicaid-insured children (ages 0–18 years) treated between April 1, 2008 to December 31, 2016 were selected and analyzed. We assessed pre- and post-law trends in concussion-related medical encounters using an ARIMA intervention model. We also used traditional regression methods to validate the study results.ResultsA total of 16,943 concussion-related medical encounters sustained by 15,545 unique patients were included. Monthly rates of concussion-related medical encounters significantly increased from 4.64 per 10,000 member months during the pre-law period to 6.69 per 10,000 member months in the post-law period (P < 0.0001). Three upward breaks in the monthly rates of concussion-related medical encounters were observed between 2009 and 2016, with two breaks observed during the pre-law period. Specifically, the increased breakpoint observed in July 2011 (P = 0.0186) was significantly associated with an estimated 7.3% increase (95% CI: 1.1–13.7) in the rate of concussion-related medical encounters. This finding was confirmed in the Poisson regression and curve fitting models. Furthermore, a seasonal trend in concussion-related medical encounters was observed with the highest rates in September and October of each year.ConclusionsTwo of the three upward breaks identified in the monthly rate of concussion-related medical encounters occurred before the enactment of Ohio’s concussion law, suggesting a potential “spillover” effect. Further research is needed to confirm such an effect in children with other types of medical insurance.

Opioid-limiting legislation associated with decreased 30-day opioid utilization following anterior cervical decompression and fusion

BACKGROUND CONTEXTSince 2016, 35 of 50 US states have passed opioid-limiting laws. The impact on postoperative opioid prescribing and secondary outcomes following anterior cervical discectomy and fusion (ACDF) remains unknown. PURPOSETo evaluate the effect of opioid-limiting regulations on postoperative opioid prescriptions, emergency department (ED) visits, unplanned readmissions, and reoperations following elective ACDF. STUDY DESIGN/SETTINGRetrospective review of prospectively-collected data. PATIENT SAMPLETwo hundred and eleven patients (101 pre-law, 110 post-law) undergoing primary elective 1–3 level ACDF during specified pre-law (December 1st, 2015–June 30th, 2016) and post-law (June 1st, 2017–December 31st, 2017) study periods were evaluated. METHODSDemographic, medical, surgical, clinical, and pharmacological data was collected from all patients. Total morphine milligram equivalents (MMEs) filled was compared at 30-day postoperative intervals, before and after stratification by preoperative opioid-tolerance. Thirty- and 90-day ED visit, readmission, and reoperation rates were calculated. Independent predictors of increased 30-day and chronic (>90 day) opioid utilization were evaluated. RESULTSDemographic, medical, and surgical factors were similar pre-law versus post-law (all p>.05). Post-law, ACDF patients received fewer opioids in their first postoperative prescription (26.65 vs. 62.08 pills, p<.001; 202.23 vs. 549.18 MMEs, p<.001) and in their first 30 postoperative days (cumulative 30-day MMEs 444.14 vs. 877.87, p<.001). Furthermore, post-law reductions in cumulative 30-day MMEs were seen among both opioid-naïve (363.54 vs. 632.20 MMEs, p<.001) and opioid-tolerant (730.08 vs. 1,122.90 MMEs, p=.022) patient populations. Increased 30-day opioid utilization was associated with surgery in the pre-law period, preoperative opioid exposure, preoperative benzodiazepine exposure, and number of levels fused (all p<.05). Chronic (>90 day) opioid requirements were associated with preoperative opioid exposure (odds ratio 4.42, p<.001) but not with pre/post-law status (p>.05). Pre- and post-law patients were similar in terms of 30- or 90-day ED visits, unplanned readmissions, and reoperations (all p>.05). CONCLUSIONSImplementation of mandatory opioid prescribing limits effectively decreased 30-day postoperative opioid utilization following ACDF without a rebound increase in prescription refills, ED visits, unplanned hospital readmissions, or reoperations for pain.

306. Opioid-limiting legislation effectively decreases 30-day opioid utilization following anterior cervical decompression and fusion

BACKGROUND CONTEXT Since 2016, over half of US states have passed mandatory opioid-limiting laws. The impacts of such mandates on postoperative opioid prescribing and secondary outcomes following anterior cervical discectomy and fusion (ACDF) have not been previously described. PURPOSE The purpose of this study is to evaluate the impact of newly implemented statewide opioid-limiting regulations in Rhode Island on postoperative opioid prescriptions, emergency department (ED) visits, unplanned readmissions and reoperations following elective ACDF. STUDY DESIGN/SETTING Retrospective review of prospectively-collected data PATIENT SAMPLE A total of 211 patients undergoing primary elective 1-3 level ACDF during specified pre-law (12/01/15 - 06/30/16) and post-law (06/01/17 - 12/31/17) study periods were considered eligible for study inclusion. Patients undergoing ACDF for trauma or other emergencies, requiring corpectomy, undergoing simultaneous procedures, or undergoing ACDF as part of a staged procedure were excluded. OUTCOME MEASURES Primary outcome measures included the number of prescriptions and total morphine milligram equivalents (MMEs) filled at 30-day postoperative intervals for 4 months following ACDF. Secondary outcome measures included prescription refill requests as well as 30-day and 90-day ED visits, readmissions and reoperations. METHODS Demographic, medical, surgical, clinical and pharmacological data were collected from all eligible patients. Those not filling any opioid prescriptions within the 30-day preoperative period were considered opioid-naive. Patients filling at least one opioid prescription in the 30-day preoperative period were considered opioid-tolerant. Cumulative oral morphine milligram equivalents (MMEs) filled were compared at 30-day postoperative intervals following ACDF, before and after stratification by preoperative opioid-tolerance and pre/post-law status. The mean number of prescription refills required within 30-days of surgery was also compared between groups. Thirty- and 90-day ED visit, readmission and reoperation rates were calculated. Independent predictors of increased 30-day and chronic (>90 day) opioid utilization were evaluated using backwards stepwise linear and logistic regression modeling respectively. RESULTS Demographic, medical and surgical factors were similar between pre-law and post-law patients (all p>0.05). Post-law, ACDF patients received fewer opioids in their first postoperative prescription (26.65 pills post-law vs 62.08 pills pre-law, p 90 day) opioid requirements were associated with preoperative opioid-tolerance (OR 4.42, p 0.05). Pre- and post-law patients were similar in terms of 30- and 90-day ED visit, unplanned readmission, and reoperation rates (all p>0.05). CONCLUSIONS Implementation of mandatory opioid prescribing limits effectively decreased 30-day postoperative opioid utilization following ACDF, regardless of preoperative opioid tolerance and without a rebound increase in prescription refills, ED visits, unplanned hospital readmissions, or reoperations. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Changes in motorcycle-related injuries and deaths after mandatory motorcycle helmet law in a district of Vietnam

ABSTRACTObjective: Our study measured the change in head injuries and deaths among motorcycle users in Cu Chi district, a suburban district of Ho Chi Minh City.Methods: Hospital records for road traffic injuries (RTIs) were collected from the Cu Chi Trauma Centre and motorcycle-related death records were obtained from mortality registries in commune health offices. Head injury severity was categorized using the Abbreviated Injury Score (AIS). Rate ratios (RRs) were used to compare rates pre- and post-law (2005/2006–2009/2010). Cu Chi's population, stratified by year, age, and sex, was used as the denominator.Results: Of records identifying the transportation mode at the time of injury, motorcyclists accounted for most injuries (3,035, 87%) and deaths (238, 90%). Head injuries accounted for 70% of motorcycle-related hospitalizations. Helmet use was not recorded in any death records and not in 97% of medical records. Males accounted for most injuries (73%) and deaths (88%). The median age was 28 years and 32 years for injuries and deaths, respectively. Compared to the pre-law period, rates of motorcycle injuries (RR = 0.53; 95% confidence interval [CI], 0.49–0.58), head injuries (RR = 0.35; 95% CI, 0.31–0.39), severe head injuries (RR = 0.47; 95% CI, 0.34–0.63), and deaths (RR = 0.69; 95% CI, 0.53–0.89) significantly decreased in the post-law period.Conclusions: Rates of head injuries and deaths among motorcycle riders decreased significantly after implementation of the mandatory helmet law in Vietnam. To further examine the impact of the motorcycle helmet law, including compliance and helmet quality, further emphasis should be placed on gathering helmet use data from injured motorcyclists.

Segmented regression analysis of interrupted time series data to assess outcomes of a South American road traffic alcohol policy change

BackgroundIn Chile, a new law introduced in March 2012 decreased the legal blood alcohol concentration (BAC) limit for driving while impaired from 1 to 0.8 g/l and the legal BAC limit for driving under the influence of alcohol from 0.5 to 0.3 g/l. The goal is to assess the impact of this new law on mortality and morbidity outcomes in Chile. MethodsA review of national databases in Chile was conducted from January 2003 to December 2014. Segmented regression analysis of interrupted time series was used for analyzing the data. In a series of multivariable linear regression models, the change in intercept and slope in the monthly incidence rate of traffic deaths and injuries and association with alcohol per 100,000 inhabitants was estimated from pre-intervention to postintervention, while controlling for secular changes. In nested regression models, potential confounding seasonal effects were accounted for. All analyses were performed at a two-sided significance level of 0.05. ResultsImmediate level drops in all the monthly rates were observed after the law from the end of the prelaw period in the majority of models and in all the de-seasonalized models, although statistical significance was reached only in the model for injures related to alcohol. After the law, the estimated monthly rate dropped abruptly by −0.869 for injuries related to alcohol and by −0.859 adjusting for seasonality (P < 0.001). Regarding the postlaw long-term trends, it was evidenced a steeper decreasing trend after the law in the models for deaths related to alcohol, although these differences were not statistically significant. ConclusionsA strong evidence of a reduction in traffic injuries related to alcohol was found following the law in Chile. Although insufficient evidence was found of a statistically significant effect for the beneficial effects seen on deaths and overall injuries, potential clinically important effects cannot be ruled out.

Impact of a new mandatory reporting law on reporting and identification of child sexual abuse: A seven year time trend analysis

Child sexual abuse is widespread and difficult to detect. To enhance case identification, many societies have enacted mandatory reporting laws requiring designated professionals, most often police, teachers, doctors and nurses, to report suspected cases to government child welfare agencies. Little research has explored the effects of introducing a reporting law on the number of reports made, and the outcomes of those reports. This study explored the impact of a new legislative mandatory reporting duty for child sexual abuse in the State of Western Australia over seven years. We analyzed data about numbers and outcomes of reports by mandated reporters, for periods before the law (2006–2008) and after the law (2009–2012). Results indicate that the number of reports by mandated reporters of suspected child sexual abuse increased by a factor of 3.7, from an annual mean of 662 in the three year pre-law period to 2448 in the four year post-law period. The increase in the first two post-law years was contextually and statistically significant. Report numbers stabilized in 2010–2012, at one report per 210 children. The number of investigated reports increased threefold, from an annual mean of 451 in the pre-law period to 1363 in the post-law period. Significant decline in the proportion of mandated reports that were investigated in the first two post-law years suggested the new level of reporting and investigative need exceeded what was anticipated. However, a subsequent significant increase restored the pre-law proportion, suggesting systemic adaptive capacity. The number of substantiated investigations doubled, from an annual mean of 160 in the pre-law period to 327 in the post-law period, indicating twice as many sexually abused children were being identified.

Assessing the effect of Michigan's smoke-free law on air quality inside restaurants and casinos: a before-and-after observational study

ObjectivesTo assess the effect of Michigan's smoke-free air (SFA) law on the air quality inside selected restaurants and casinos. The hypothesis of the study: if the SFA law is effectively...

The immediate effect of the Same-Sex Marriage Prohibition Act on stigma, discrimination, and engagement on HIV prevention and treatment services in men who have sex with men in Nigeria: analysis of prospective data from the TRUST cohort

In January, 2014, the Same-Sex Marriage Prohibition Act was signed into law in Nigeria, further criminalising same-sex sexual relationships. We aimed to assess the immediate effect of this prohibition act on stigma, discrimination, and engagement in HIV prevention and treatment services in men who have sex with men (MSM) in Nigeria. The TRUST cohort study uses respondent-driven sampling to assess the feasibility and effectiveness of engagement of MSM in HIV prevention and treatment services at a clinical site located with a community-based organisation trusted by the MSM community. TRUST is a prospective implementation research cohort of MSM (≥16 years) in Abuja, Nigeria. We compared HIV clinical outcomes and stigma, including fear and avoidance of health care, across baseline and quarterly visits before and after implementation of the the Same-Sex Marriage Prohibition Act. Outcomes assessed were measures of stigma and discrimination, loss to follow-up, antiretroviral therapy status, and viral load. We compared outcomes before and after the legislation with χ2 statistics, and estimated incident stigma-related events and loss to follow-up with Poisson regression. Between March 19, 2013, and Aug 7, 2014, 707 MSM participated in baseline study procedures, contributing to 756 before legislation (prelaw) and 420 after legislation (postlaw) visits. Reported history of fear of seeking health care was significantly higher in postlaw visits than in prelaw visits (n=161 [38%] vs n=187 [25%]; p<0・0001), as was avoidance of health care (n=118 [28%] vs n=151 [20%]; p=0・001). In incidence analyses, of 192 MSM with follow-up data and no history of an event at baseline, reported fear of seeking health care was higher in the postlaw than the prelaw period (n=144; incidence rate ratio 2・57, 95% CI 1・29–5・10; p=0・007); loss to follow-up and incident healthcare avoidance were similar across periods. Of the 161 (89%) of 181 HIV-infected MSM with HIV viral loads available, those who had disclosed sexual behaviour with a health-care provider were more often virally suppressed at baseline than those with no previous disclosure (18 [29%] of 62 vs 13 [13%] of 99 men; p=0・013). These analyses represent individual-level, quantitative, real-time prospective data for the health-related effects resulting from the enactment of legislation further criminalising same-sex practices. The negative effects of HIV treatment and care in MSM reinforce the unintended consequences of such legislation on global goals of HIV eradication. Strategies to reach MSM less likely to engage in HIV testing and care in highly stigmatised environments are needed to reduce time to HIV diagnosis and treatment. National Institutes of Health.

The Impact of the Israeli Transplantation Law on the Socio-Demographic Profile of Living Kidney Donors

The Israeli transplantation law of 2008 stipulated that organ trading is a criminal offense, and banned the reimbursement of such transplants by insurance companies, thus decreasing dramatically transplant tourism from Israel. We evaluated the law's impact on the number and the socio-demographic features of 575 consecutive living donors, transplanted in the largest Israeli transplantation center, spanning 5 years prior to 5 years after the law's implementation. Living kidney donations increased from 3.5 ± 1.5 donations per month in the pre-law period to 6.1 ± 2.4 per month post-law (p < 0.001). This was mainly due to a rise in intra-familial donations from 2.1 ± 1.1 per month to 4.6 ± 2.1 per month (p < 0.001). In unrelated donors we found a significant change in their socio-demographic characteristics: mean age increased from 35.4 ± 7.4 to 39.9 ± 10.2 (p = 0.001), an increase in the proportion of donors with college level or higher education (31.0% to 63.1%; p < 0.001) and donors with white collar occupations (33.3% to 48.3%, p = 0.023). In conclusion, the Israeli legislation that prohibited transplant tourism and organ trading in accordance with Istanbul Declaration, was associated with an increase in local transplantation activity, mainly from related living kidney donors, and a change in the profile of unrelated donors into an older, higher educated, white collar population.

Auditors' Going Concern Reporting in the Pre- and Post-Bankruptcy Law Eras: Chinese Affiliates of Big 4 versus Local Auditors

Unlike the situation in most developed countries, before the enactment of China's 2006 Bankruptcy Law it was difficult for Chinese-listed companies, which were mostly government owned, to declare bankruptcy. Our analysis of a sample of Chinese financially-distressed companies from 2001 to 2010 reveals that the Chinese affiliates of Big 4 auditors had a higher propensity to issue going concern (GC) reports than local auditors not only in the post-law period, but also in the pre-law period. This finding suggests that Big 4 auditors had incentives to maintain their reputations even when the clients' bankruptcy risk was low. We also find that there was a significant increase in local top-10 auditors' GC reporting propensity in the post-law period, which is consistent with the notion that the increased litigation/regulation risk due to the enactment of Bankruptcy Law has an effect on local large auditors.

The impact of mandatory helmet law on the outcome of maxillo facial trauma: a comparative study in kerala.

Motorcyclists comprise the majority of road-traffic victims in low and middle income countries,and consequently, the majority of the road-traffic victims globally. Simple measures can be taken to make safer on the roads, which include enforcement of safety measures like seat belt and helmets. The compulsory Helmet law was enforced in Kerala on 18/06/07. Resistance to legislation on motorcycle helmets still coexists world wide with debate on the effectiveness of helmets. In an attempt to analyze the protective effect of helmets on facial injuries a comparative study was conducted in Government Dental College, Calicut, which is a major trauma centre in northern Kerala. Data for the present study was obtained from the patients who have reported to the Emergency Department of Oral and Maxillofacial Surgery, Government Dental College, Calicut, for a period of 6 months immediately after the implementation of strict helmet rule in Kerala. For the study all patients with a history of nonfatal motor cycle accident sustaining facial injuries were included. The results were compared with the study conducted in the same institution in the pre law period. The study demonstrates the protective effect of motorcycle helmets in decreasing the morbidity of maxillofacial trauma.There was a marked decrease in incidence of motorcycle-related injuries, remarkable increase in helmet usage and better outcome in helmeted individuals in the post law period. Road traffic injury control is a public health problem. Health and medical professionals have an ethical responsibility to educate and arrange for the safety of individuals. Helmets are effective in preventing or reducing the severity of motorcycle-related injuries and in a developing country like India, enforced mandatory motor cycle helmet law is potentially one of the most cost effective interventions available.

Alcohol consumption among high-risk Thai youth after raising the legal drinking age

ObjectiveMethamphetamine and alcohol are the leading substances abused by Thai youth. In 2008 the government passed laws that limited alcohol availability and increased the legal drinking age from 18 to 20. We assessed whether the law reduced drinking among methamphetamine-using 18–19 year olds in Chiang Mai. MethodThe study compares drinking patterns among methamphetamine smokers aged 18–19 years (n=136) collected prior to the legal changes, to a comparable post-law sample (n=142). Statistical tests for differences between the pre- and post-law samples on problem drinking and recent drinking frequency and drunkenness were conducted. Logistic regression modeled the relative odds of frequent drunkenness, controlling for demographic characteristics. ResultsA high prevalence of problematic drinking was present in both samples, with no difference detected. The post-law sample reported a significantly higher median days drunk/month (9 vs. 4, p≤0.01); in adjusted analysis, frequent drunkenness (>5.5 days/month) was more common in the post-law compared to pre-law period in the presence of other variables (AOR: 2.2; 95%CI: 1.3, 3.9). Post-law participants demonstrated a low level of knowledge about the law's components. ConclusionsThe study suggests that the new laws did not reduce drinking among high-risk, methamphetamine-smoking 18–19 year olds; rather, the post-law period was associated with increased drinking levels. The data indicate that the law is not reaching high-risk under-aged youth who are at risk of a number of deleterious outcomes as a result of their substance use.

Graduated Driver Licensing Decal Law: Effect on Young Probationary Drivers

Decal laws have been implemented internationally to facilitate police enforcement of graduated driver licensing (GDL) restrictions (e.g., passenger limit, nighttime curfew) but have not been evaluated. New Jersey implemented the first decal law in the U.S. on May 1, 2010. The aim of this study was to evaluate the effect of New Jersey's law on the rate of citations issued for violation of GDL restrictions and police-reported crashes among probationary drivers aged <21 years and to estimate the number of probationary drivers whose crashes were prevented by the law. New Jersey's licensing and crash databases were linked from January 1, 2008 to May 31, 2011, and each driver's license status, age, and outcome status were ascertained for each month. Monthly rates were calculated as the proportion of probationary drivers who experienced the outcome in that month. The pre-law period was defined as January 2008-January 2010 and the post-law period as May 2010-May 2011. Negative binomial regression models with robust SEs were used to determine the law's effect on crash and citation rates (adjusted for gender, seasonal trends, and overall trends) and estimate prevented crashes. Analyses were conducted in 2012. In the first year post-law, there was a 14% increase in the GDL citation rate (adjusted rate ratio 1.14 [95% CI=1.05, 1.24]); a 9% reduction in the police-reported crash rate (adjusted rate ratio 0.91 [95% CI=0.86, 0.97]), and an estimated 1624 young probationary drivers for whom a crash was prevented. Findings suggest that the law is positively affecting probationary drivers' safety. Results contribute to building the evidence base for the effectiveness of decal laws and provide valuable information to U.S. and international policymakers who are considering adding decal laws to enhance existing GDL laws.

Effects of Booster Seat Laws on Injury Risk Among Children in Crashes

Objective: Belt-positioning booster seats have been shown to reduce injury risk among child passengers aged 4 to 8 in motor vehicle crashes. To encourage the use of booster seats, many states have enacted laws that require the use of either a child restraint with internal harness or a belt-positioning booster seat, but the specific age range covered by the laws varies by state. Previous studies have found evidence that booster seat laws are effective in reducing injury risk among children, but these studies primarily have included states with younger age requirements (e.g., ages 4–6) for booster seats. The objective of the present study was to examine the effectiveness of booster seat laws in several states that cover children through age 7 or 8. Methods: Police-reported crash data from 5 states—Missouri, North Carolina, Pennsylvania, Wisconsin, and Wyoming—were used to compare population-based injury rates, restraint use, and seating position among children before and after booster seat laws. The pre-law period was comprised of the 2 calendar years prior to the year of enactment of the booster seat law, and the post-law period was comprised of the 2 calendar years after the year of the effective start of the booster seat law. Effectiveness estimates were adjusted using a comparison group of children aged 9 to 12 in the same states who were not covered by the booster seat laws. Results: Among children in crashes who were affected by law changes in the 5 study states, the per capita rate of children using child safety seats (either a harnessed child restraint or booster seat) increased nearly 3 times, and the per capita rate of children riding in rear seats increased 6 percent after the booster seat laws were implemented. Booster seat laws were associated with a 5 percent reduction in the per capita rate of children who sustained injuries of any severity and a 17 percent reduction in the per capita rate of children who sustained fatal or incapacitating injuries. Conclusions: Results provide evidence that booster seat laws are effective in increasing the use of child safety seats, increasing the placement of children in rear seats, and reducing injuries, especially severe injuries, among children covered by the laws. [Supplementary materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention for the following free supplemental resource(s): Appendix – Population, counts of children injured, and injury rates per 10,000 population for each state before and after amendments strengthening child restraint laws.]