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Understanding long-term trends in injury morbidity is critical to prevention and intervention planning. The aim of this study was to assess long-term trends in injury morbidity rates in China from 1993 to 2013. Using data from the National Health Service Survey (NHSS), which is conducted every five years, crude and age-standardized prevalence during the previous two weeks and hospitalization rates in the last 12 months with 95% confidence intervals (CI) were calculated. The Rao-Scott Chi-square test examined injury morbidity differences across the five survey years by location (urban/rural), sex, age group, and household income. Percent changes in morbidity rate were approximated using logistic regressions. Sampling weights were applied to all analyses. In 2013, crude two-week injury prevalence in China was 0.46% (95% CI: 0.40%, 0.52%) and 12-month crude hospitalization rate was 0.70% (95% CI: 0.63%, 0.77%). Age-standardized injury prevalence increased 31.4% (95% CI: 7.6%, 60.6%) between 1993 and 2013 (29.4%, 95% CI: 6.7%, 56.9% from 1993–2003; 1.6%, 95% CI: -14.8%, 21.0% from 2003–2013), and age-standardized hospitalization rates rose 107.2% (95% CI: 75.1%, 145.2%) from 1993 to 2013 (-9.5%, 95% CI: -24.6%, 8.6% from 1993–2003 and 129.0%, 95% CI: 93.9%, 170.4% from 2003–2013). Subgroup analyses showed similar trends over time. The leading cause of injury was dislocation, sprain or strain for prevalence, and fractures for hospitalization. In conclusion, injury morbidity increased substantially from 1993 to 2013 in China. Inconsistent changes in two-week prevalence and 12-month hospitalization rate merit attention from researchers and policy-makers. [ABSTRACT FROM AUTHOR]

Introduction: Hollow viscus injuries (HVIs) are uncommon but potentially catastrophic conditions with high mortality and morbidity rates. The aim of this study was to analyze our 16-year experience with patients undergoing surgery for blunt or penetrating bowel trauma to identify prognostic factors with particular attention to the influence of diagnostic delay on outcome.Methods: From our multicenter trauma registry, we selected 169 consecutive patients with an HVI, enrolled from 2000 to 2016. Preoperative, intraoperative, and postoperative data were analyzed to assess determinants of mortality, morbidity, and length of stay by univariate and multivariate analysis models.Results: Overall mortality and morbidity rates were 15.9% and 36.1%, respectively. The mean length of hospital stay was 23±7 days. Morbidity was independently related to an increase of white blood cells (P=0.01), and to delay of treatment >6 hours (P=0.033), while Injury Severity Score (ISS) (P=0.01), presence of shock (P=0.01), and a low diastolic arterial pressure registered at emergency room admission (P=0.02) significantly affected postoperative mortality.Conclusion: There is evidence that patients with clinical signs of shock, low diastolic pressure at admission, and high ISS are at increased risk of postoperative mortality. Leukocytosis and delayed treatment (>6 hours) were independent predictors of postoperative morbidity. More effort should be made to increase the preoperative detection rate of HVI and reduce the delay of treatment. [ABSTRACT FROM AUTHOR]

Background: Injury is an increasingly important health problem particularly in developing countries like India. Community-based studies are of paramount importance to develop preventive measures. Not many community-based studies have been done to assess the burden and nature of injury in India and the State of Tamil Nadu. Methods: A systematic random sample of households was selected from each of two selected Health sub-centers. All adult members were interviewed with a semi-structured questionnaire to collect information on unintentional injuries in a 30-day recall period. For children below 5 years, a responsible adult member (mostly mother or father) of the family was interviewed. Results: Totally 2216 members were surveyed in 502 households. The overall incidence of unintentional injuries was 9.6 % [95% Confidence Interval (CI): 8.4, 10.9]. Incidence was lowest in 15-44 age-groups and highest in 0-4 age-group (8.7% Vs 12.2%). The incidence was high in male than female (χ²= 10.88; p <0.001). All reported injuries were nonfatal in nature. The common types of injuries were minor injuries, falls, animal and insect bites and traffic injuries. The incidence of minor injuries was high (3.4%) compared to other types like falls (2.9%) and animal bite (1.6%). No injury was reported due to accidental poisoning and drowning. Conclusions: The incidence of unintentional injuries was found to be low in the present study. However, further studies using larger and more representative samples are needed to delineate the problem of unintentional injuries and their risk factors in rural Tamil Nadu. [ABSTRACT FROM AUTHOR]

Background: When there is an insurgency, the use of force in the form of weaponry, is employed. This may lead to the total breakdown of law and order, resulting in destruction of life and property. Health workers may be killed or captured, and, health facilities destroyed or stretched beyond their functional capacity. This is a report of experience with injuries seen in a tertiary hospital in north eastern Nigeria, under an insurgency situation. Materials and Methods: After obtaining clearance from the medical Ethics Committee of UMTH, we reviewed the case files of all patients treated for injuries sustained as a result of the Boko Haram insurgency from January 2009 to December 2013. Those brought in dead, were not included in the study. Results: We reviewed the case files, theatre notes, admission and discharge registers of 1339 cases. 1223 (91.3%) of the victims were males, while 116 (8.7%) were females. Gunshot wounds accounted for 1229 (91.8%) of the injuries, bomb blast 90 (6.7%), others 15 (1.1%) knife (Cut throat) 4 (0.3%) and road traffic accident 1 (0.01%). Casualties were made up of civilians 1144 (85.4%), the joint task force (a force made up of the Military, Police, Customs and Immigration, against the insurgents) 117 (8.7%), and insurgents 22 (1.6%). The ages of the patients ranged from 1 to 80 years, peaking at the 21-40 age brackets (796 or 59.4%). The extremities were most affected, 734 (54.8%), followed by the torso 423 (31.6%), multiple injuries 93 (6.9%) and head and neck 89 (6.6%). 1226 (91.6%) of the victims survived while 113 (8.4%) died from their injuries. This followed massive blood loss from injuries to the torso 69 (61.1%) multiple injuries 15 (13.3) and extremities 6 (5.3%). Others causes were fatal injuries to the head and neck 22 (19.5%) and 90% burns following bomb blast 1 (0.9%). Conclusion: Injuries resulting from insurgency will continue to be a problem in many developing countries because their health facilities in terms of personnel and materials are ill prepared for such a situation. [ABSTRACT FROM AUTHOR]

This study aimed at analysing first-time hospitalisations for traumatic brain injury (TBI) and spinal cord injury (SCI) in Western Australia (WA), in terms of socio-demographic profile, cause of injury, relative risks and survival, using tabular and regression analyses of linked hospital discharge and mortality census files and comparing results with published standardised mortality rates (SMRs) for TBI. Participants were all 9,114 first hospital admissions for TBI or SCI from 7/2003 to 6/2008, linked to mortality census data through 12/2008, and the main outcome measures were number of cases by cause, SMRs in hospital and post-discharge by year through year 5. Road crashes accounted for 34 % of hospitalised TBI and 52 % of hospitalised SCI. 8,460 live TBI discharges experienced 580 deaths during 24,494 person-years of follow-up. The life-table expectation of deaths in the cohort was 164. Post-discharge SMRs were 7.66 in year 1, 3.86 in year 2 and averaged 2.31 in years 3 through 5. 317 live SCI discharges experienced 18 deaths during 929 years of follow-up. Post-discharge SMRs were 7.36 in year 1 and a fluctuating average of 2.13 in years 2 through 5. Use of data from model systems does not appear to yield biased SMRs. Similarly no systematic variation was observed between all-age studies and the more numerous studies that focused on those aged 14 to 16 and older. Based on two studies, SMRs for TBI, however, may be higher in year 2 post-discharge in Australia than elsewhere. That possibility and its cause warrant exploration. Expanding public TBI/SCI compensation in WA from road crash to all causes might triple TBI compensation and double SCI compensation. [ABSTRACT FROM AUTHOR]

This paper examines college athletes' perceived support for concussion reporting from coaches and teammates and its variation by year-in-school, finding significant differences in perceived coach support. It also examines the effects of perceived coach support on concussion reporting behaviors, finding that greater perceived coach support is associated with fewer undiagnosed concussions and returning to play while symptomatic less frequently in the two weeks preceding the survey. Coaches play a critical role in athlete concussion reporting. [ABSTRACT FROM AUTHOR]

Background: National trauma registries have helped improve patient outcomes across the world. Recently, the idea of an International Trauma Data Bank (ITDB) has been suggested to establish global comparative assessments of trauma outcomes. The objective of this study was to determine whether global trauma data could be combined to perform international outcomes benchmarking. Methods: We used observed/expected (O/E) mortality ratios to compare two trauma centers [European high-income country (HIC) and Asian lower-middle income country (LMIC)] with centers in the North American National Trauma Data Bank (NTDB). Patients (≥16 years) with blunt/penetrating injuries were included. Multivariable logistic regression, adjusting for known predictors of trauma mortality, was performed. Estimates were used to predict the expected deaths at each center and to calculate O/E mortality ratios for benchmarking. Results: A total of 375,433 patients from 301 centers were included from the NTDB (2002-2010). The LMIC trauma center had 806 patients (2002-2010), whereas the HIC reported 1,003 patients (2002-2004). The most important known predictors of trauma mortality were adequately recorded in all datasets. Mortality benchmarking revealed that the HIC center performed similarly to the NTDB centers [O/E = 1.11 (95 % confidence interval (CI) 0.92-1.35)], whereas the LMIC center showed significantly worse survival [O/E = 1.52 (1.23-1.88)]. Subset analyses of patients with blunt or penetrating injury showed similar results. Conclusions: Using only a few key covariates, aggregated global trauma data can be used to adequately perform international trauma center benchmarking. The creation of the ITDB is feasible and recommended as it may be a pivotal step towards improving global trauma outcomes. [ABSTRACT FROM AUTHOR]

Until recently, vessel collisions with small cetaceans were presumed rare, mainly as a consequence of limited reporting. Observations on dolphin wound healing from propeller strike injuries also remain scarce. We present an extreme case of a bottlenose dolphin (Tursiops truncatus) with multiple propeller wounds, including a penetration to the bone, where survival was possible for at least 23 days post injury. We used photographic records in conjunction with field observations to describe wound progression in the absence of treatment. Considering the severity of the wounds, it was surprising that the injuries were not immediately fatal. A practical solution remains to be found for the problem of odontocete vessel collisions, in particular for small highly mobile species using neritic waters. In view of the ongoing problem in the Hauraki Gulf and, indeed, worldwide, we recommend continued evaluation of cases and reporting of incidents, in addition to investigations into mechanisms that may reduce the risk of occurrence of vessel collisions with cetaceans. [ABSTRACT FROM AUTHOR]

Aims In England and Wales, doctors are charged with a responsibility either to report a death to the coroner or issue a medical certificate specifying cause of death. A lack of formal prescriptive or presumptive oversight has resulted in the promulgation by individual coroners of local reporting regimes. The study reported here identified overall and gendered variations in local reporting rates to coroners across the jurisdictions of England and Wales, consistent over time. Methods Analysis was performed on Ministry of Justice (MOJ) data pertaining to the numbers and proportions of deaths reported to the coroner by jurisdiction over a 10-year period (2001-2010). Office of National Statistics (ONS) data provided the numbers of deaths registered in England and Wales over the same period to serve as a denominator for the calculation of proportions. Where coroner jurisdictions (and local authorities) had been amalgamated during this period, the combined reported and registered death figures have been included in line with the current jurisdiction areas. Results While reporting rates for individual jurisdictions were found to be stable over the 10-year period, wide local variations in reporting deaths to coroners were found with no obvious demographic explanation. The gender of the deceased was identified as a major factor in local variation. Conclusions The decision to report a death to the coroner varies across jurisdictions. Implications for coronial investigations are discussed and the need for wider research into coroners' decision-making is proposed. [ABSTRACT FROM AUTHOR]

Issue addressed: This review of injury articles describes how selected primary print media sources in Australia report injury events and exploreshowthismayimpact onpublic perception of the injury risk and the opportunities itmaypresent to health professionals. Methods: Media articles specific to injury, compiled by the Public Health Advocacy Institute of Western Australia (PHAIWA) through their MediaWatch service during 2011, were collated and analysed. Articles were gathered from The West Australian, The Australian and The Sunday Times newspapers and ABC Online. Each article was categorised into injury topics and target groups, and preventive strategies were identified. Results: Of the 546 articles that contained injury as a key word, 424 articles were used for the present study. The majority of articles related to community-based injuries (65%) and the most frequent reported injury was violence and assault. The results also indicate that although there is regular media reporting on injury issues, only one-fifth of reports discuss possible preventive measures. Conclusions: Selected Australian newspapers and the ABC Online are important and low-cost sources of injury-related information for the general public and can impact how the public perceives injury. It is important for public health professionals to embrace media advocacy strategies to assist in influencing and setting local public policy. Sowhat? Public attitudes and understanding of issues are influenced by media coverage. Media monitoring is one tool to track what media sources are reporting about public health issues, the industry and stakeholders. Influencing the quantity and quality of media coverage is critical to advancing healthy public policy, particularly when advocating for prevention strategies to be reported and acted upon. Advocacy is an important health promotion strategy; it is therefore important for health professionals to understand media advocacy and position public health issues as societal issues with policy solutions. [ABSTRACT FROM AUTHOR]

Abstract: Background: Data on the epidemiology of trauma in Cameroon are scarce. Presently, hospital records are still used as a primary source of injury data. It has been shown that trauma registries could play a key role in providing basic data on trauma. Our goal is to review the present emergency ward records for completeness of data and provide an overview of injuries in the city of Limbe and the surrounding area in the Southwest Region of Cameroon prior to the institution of a formal registration system. Methods: A retrospective review of Emergency Ward logs in Limbe Hospital was conducted over one year. Records for all patients over 15 years of age were reviewed for 14 data points considered to be essential to a basic trauma registry. Completeness of records was assessed and a descriptive analysis of patterns and trends of trauma was performed. Results: Injury-related conditions represent 27% of all registered admissions in the casualty department. Information on age, sex and mechanism of injury was lacking in 22% of cases. Information on vital signs was present in 2% (respiratory rate) to 12% (blood pressure on admission) of records. Patient disposition (admission, transfer, discharge, or death) was available 42% of the time, whilst location of injury was found in 84% of records. Road traffic injury was the most frequently recorded mechanism (36%), with the type of vehicle specified in 54% and the type of collision in only 22% of cases. Intentional injuries were the second most frequent mechanism at 23%. Conclusion: The frequency of trauma found in this context argues for further prevention and treatment efforts. The institution of a formal registration system will improve the completeness of data and lead to increased ability to evaluate the severity and subsequent public health implications of injury in this region. [Copyright &y& Elsevier]

The article focuses on a study, which aims to systematically review the range of case definitions and methods used for the measurement and reporting on injurious falls in randomised controlled trials (RCTs) on fall prevention. To identify injurious falls definitions in published trials, an electronic literature search of some comprehensive databases was performed.

The purpose of this study is to evaluate the sources reporting hospitalized spinal cord injury cases to the statewide, population-based surveillance system in Colorado for the year 1994. Three reporting sources were evaluated: clinical contact persons, medical records departments, and a centralized statewide hospital discharge database. Two evaluation strategies were utilized; these include both measures of accuracy and estimates of missed cases. For the latter, capture-recapture techniques were used to estimate the number of hospitalized spinal cord injury cases missed by all three reporting sources. The clinical contact persons reported 84 confirmed cases, missed 80 confirmed cases, and reported 10 cases that were later determined not to have spinal cord injuries, resulting in a sensitivity of 0.51. Medical records departments and the discharge database reported 143 and 147 cases, respectively, missed 21 and 17 confirmed cases, and reported 118 and 69 cases that were later determined not to be cases of hospitalized injuries of the spinal cord, resulting in sensitivities of 0.87 and 0.90. Capture-recapture results indicate all three sources combined missed an estimated 1–5 cases, yielding a total annual incidence rate for hospitalized spinal cord injury ranging from 45.1 to 46.3 per million population. Am J Epidemiol 1997;146:266–72. [ABSTRACT FROM AUTHOR]

The author discusses the use the mathematical properties of family of distributions to simplify description and further analyses of injuries data. Topics discussed include the use the binomial probability distribution, statistical methods for comparing and studying linear relationships among variables, and the probability distribution. Also mentioned are measuring the injury severity scores (ISS), evaluating emergency care with distribution methods, and measurement errors.

The article focuses on the relationship of the proneness to accident and the tendency of reporting injuries. It mentions that the injury criterion is less representative in individuals who are reluctant to reports injuries. It says that the true variance associated with differential liability toward injuries is assumed as part of a systematic variance in an injury distribution. It adds that the individuals who have the maximum tendency or reporting injuries can report no more than actually occur.

The article provides information on hoverboard-related injuries reported to the Canadian Hospitals Injury Reporting and Prevention Program's electronic system as of July 7, 2016. Other topics discussed include the characteristics of the injured, nature and place of injury, and safety measures to avoid such injuries including use of proper safety gear.

The article reports that the authors have presented five recommendations to improve the quality of adverse events reporting in clinical research publication. the suggestions mentioned include identifying and communicating the most clinically relevant drug adverse event data and using statistical analysis for clinically relevant adverse events and avoiding use of overly general text descriptionsfor adverse events.

The article presents perspectives of various authors about diseases published from the previous issues of the ANZ Journal of Surgery. It states that the article of S.A. Deane and colleagues in 1988 said that injuries morbidity and mortality have been recognized as major public health issues. In addition, G.W. Milton and colleagues made a survey on 127 patients diagnosed with appendicitis, published in 1963. It says that P.G. Cecil's article in 1938 deals with surgeon's knowledge about disease.

The article presents a blank assessment chart for dentists to examine and treat acute traumatic injuries to the face and mouth, with spaces for the doctor to enter the patient's medical history; a diagram of the dental injuries to the patient's teeth; and a section for recommended treatment.

A letter to the editor is presented in response to the article "The effect of counting principal and secondary injuries on national estimates of motor vehicle related trauma," by J. Halpin and colleagues in the 2009 issue.

A correction to the article "The Canadian Hospitals Injury Reporting and Preventive Program: a dynamic and innovative injury surveillance system" that was published in the 2016 is presented.

An abstract of the article "Systematic literature review to identify templates for reporting pre-hospital major incident medical management," by S. Fattah and colleagues is presented.