Risk Of Accidental Injury Research Articles

Home Safety Program for Older Adults

A disproportionately high number of older adults are involved in home accidents at considerable cost to both the individual and the nation. Preventive measures are cost-effective and easy to accomplish, and occupational therapists are uniquely qualified to educate older adults about ways to modify their environment or activities of daily living to lessen the risk of accidental injury. This article describes the developmcnt and operation of a Home Safety Program for Older. Adults in an agency on aging in Charlottesville, VA. The program has two components: safety improvements for individual homes, and community education. Funding, services and staff are discussed and recommendations are made for replication.

Individual characteristics as predictors of accidental injuries in naval personnel

Personnel characteristics and occupational factors were investigated in order to identify groups with elevated risks of accidental injury in naval environments during first enlistments. The individual characteristics of age at enlistment, educational level, and mental ability all were found to relate significantly to injury when considered singly. When considered jointly, however, only education had a major effect on injury rate. In general, the results indicated that the same individual characteristics that predict poor military performance also predict risk of accidental injury. The occupational analysis identified a number of high-risk occupational specialties (occupations with injury rates above the Navy norm). With the exception of Hospital Corpsmen, all of these occupations were engineering, construction, or aviation specialties in which exposure to hazardous machinery or equipment was evident. Improved safety training and closer supervision should be considered for these personnel, particularly nonhigh school graduates. A modified life table technique was found to be appropriate for this type of longitudinal analysis where large and uneven withdrawals from the cohort occurred. Further analyses of large cohorts from high-risk occupations will be needed to understand the causal factors underlying observed differences in injury rate.

Therapy of Petit Mal (Absence) Seizures

Although petit mal or typical absence seizures are not life threatening, it is important for the pediatrician to recognize the disorder because untreated they can affect school performance, increase the risk of accidental injury, and lead to the victim's being ridiculed by classmates for being "spacey." CLASSIFICATION Unfortunately, petit mal is probably the most misused term in epileptology. In 1969, The International League Against Epilepsy published a classification of epileptic seizures entitled The International Classification of Epilepsy. This classification, which has recently undergone revision, categorizes seizures into two groups: partial, seizures in which the first clinical and electroencephalographic changes indicate initial activation of a system of neurons limited to a part of one cerebral hemisphere, and generalized, those in which the first clinical changes indicate initial involvement of both hemispheres. In absence seizures, as in all primary generalized seizures, the ictal EEG patterns are bilateral and reflect neuronal discharge which is widespread. Absence seizures can be further subdivided into typical and atypical absences (Table 1). Although the term petit mal has been eliminated from the revised International Classification of Seizures, the term is still widely used by physicians. Most physicians use it to describe a simple absence with impairment of consciousness only, and with a rhythmic, three cycles per second, spike and wave discharge on the electroencephalogram in a child between age 3 years and puberty who has normal intelligence and in whom a neurologic examination prduces normal findings.

Therapy of Petit Mal (Absence) Seizures

Although petit mal or typical absence seizures are not life threatening, it is important for the pediatrician to recognize the disorder because untreated they can affect school performance, increase the risk of accidental injury, and lead to the victim9s being ridiculed by classmates for being spacey. CLASSIFICATION Unfortunately, petit mal is probably the most misused term in epileptology. In 1969, The International League Against Epilepsy published a classification of epileptic seizures entitled The International Classification of Epilepsy. This classification, which has recently undergone revision, categorizes seizures into two groups: partial, seizures in which the first clinical and electroencephalographic changes indicate initial activation of a system of neurons limited to a part of one cerebral hemisphere, and generalized, those in which the first clinical changes indicate initial involvement of both hemispheres. In absence seizures, as in all primary generalized seizures, the ictal EEG patterns are bilateral and reflect neuronal discharge which is widespread. Absence seizures can be further subdivided into typical and atypical absences (Table 1). Although the term petit mal has been eliminated from the revised International Classification of Seizures, the term is still widely used by physicians. Most physicians use it to describe a simple absence with impairment of consciousness only, and with a rhythmic, three cycles per second, spike and wave discharge on the electroencephalogram in a child between age 3 years and puberty who has normal intelligence and in whom a neurologic examination prduces normal findings.

Prevention of Childhood Accidents: Recent Progress

Accidents, the major source of death and disability the child over age 1, are amenable to prevention. Accidents and their prevention can be better understood if viewed as a coincidence time of agent, environment, and victim predispositions. One can intervene at any of these three sites using either active or passive modes to prevent the accident. Much of the progress child safety reviewed this article is the result of improved government product safety standards which generally result passive modes of accident prevention by modifying the agent (eg, flame-retardant sleepwear). These regulations are highlighted partly because they provide very tangible efforts and partly because the logical site for primary accident prevention is the manufacture of safe products. Modification of the victim and his environment more often requires individual effort and active modes of prevention. Although sometimes less tangible, this motivating role that the individual clinician must fill should not be minimized. Regulations are not likely to prevent many childhood accident hazards (eg, coffee cups), but physicians can remind parents of the risk. We have seen that physicians can be effective this motivating role encouraging the use of automobile restraints for children. Physician input is needed to recognize the correctable hazards of the environment and lobby for their improvement. A primary goal for the early 1980s should be safe packaging of children for automobile rides. Effective passive restraints for children would be best, but we will also need to work for an intermediate step of child restraint laws individual states. The physicians in the trenches will be needed to help parents recognize the age-appropriate hazards of childhood which regulations cannot prevent. The physicians will also be the ones to recognize and treat stressed families that are at greatest risk of accidental injury.

Comparative risk assessment of energy systems

Nearly all energy systems entail some significant forms of health, environmental, or socio-political risks. But there is considerable difference among various energy systems in the magnitude, timing, and nature of their associated risks. It is this difference that allows a degree of choice, or policy, with regard to selecting energy alternatives. The National Academy of Sciences Committee on Nuclear and Alternative Energy Systems compiled a detailed analysis of risks associated with different types of energy use. A condensed table of that analysis is presented. The issue of assessing risks is also discussed, to give the reader an idea of the complications involved in making valid risk assessments, and the worth of risk assessment as a public policymaking device. Among questions raised: Can risks and benefits be measured in the same units? Can we, for example, compare the risk of climatic change with the risk of accidental injury or death? How much do we value the future? Are we willing to invest money today to save a life tomorrow? (This is known as valuing or discounting the future, a difficult economic value question.) Moreover, public perception of risks affects policy response to risks. There are, of course, uncertainties. The likelihood exists that many factors have not yet been assessed and that unidentified risks of a serious nature could surface. As more and more aspects are studied, additional risks will be uncovered. Because of the uncertainties and diversity of both risks and benefits associated with alternative energy systems, our embryonic methods of risk analysis must be improved. The public and its leaders must be familiar with the basics of risk analysis and be able to distinguish between issues of fact, and value issues. It is clear that we cannot rely solely on one form of energy. Diversity will provide a hedge against unforeseen risks. Risks will be proportional to the total energy produced and consumed by society. Therefore, it is essential that global population be kept in check so that total energy usage can be minimized, while per capita consumption is not too low. If more and more people use energy to improve standards of living, the ultimate adverse health, environmental and social impacts could well outweigh the benefits.