Bunk versus conventional beds: a comparative assessment of fall injury risk

Study design: Case-control investigation. Setting: Accident and emergency departments of four hospitals in Greece, namely a teaching children's hospital and a trauma hospital in Greater Athens and the two district hospitals in the Magnesia county and the Corfu island. Patients: During the three year period 1996–98, 1881 children (0–14 years) presenting with bed fall injuries were recorded by the Emergency Department Injury Surveillance System (EDISS). Out of these, 197 children with falls from bunk beds served as cases and 1684 children with falls from conventional beds served as controls. Results: From the analysis and a nationwide extrapolation, it was calculated that each year about 5000 children in Greece (total population 10 million) seek medical attendance at an emergency department for a bed injury, corresponding to an estimated incidence of about 3 per 1000 children years. Out of bed fall injuries, 10.5% are from bunk beds, 10.4% from cribs, 3.1% from cots, and 76.0% from other conventional beds. Falls from the bed ladder accounted for 8% of all bunk bed injuries. Boys are at higher risk for falls from beds but there is no evidence that the proportion is different depending on the type of bed used. Relatively few falls from bunk beds are recorded outside the crowded apartments of Greater Athens or among migrant children. The increased relative risk of injuries from bunk bed falls during the sleeping hours indicates the higher risk of injury after a fall from a bunk rather than a conventional bed. Injuries from bunk bed falls are generally more serious than those from conventional bed falls (overrepresentation of brain injuries, fractures, multiple injuries, and injuries requiring hospitalisation). Overall, it can be estimated that almost half of the sleep related bunk bed injuries are easily preventable. Conclusions: Falls from bunk beds represent a non-negligible childhood injury risk. A sizeable fraction can be avoided with simple design modifications of the product, such as use of side rails in the upper bed or removal of the bed ladder when not in use

Evaluating the impact of a school-based helmet promotion program on eligible adolescent drivers: Different audiences, different needs?

The school environment has been often identified as a prosperous venue for public health improvement. This study is a cluster randomized controlled trial evaluating the impact of a school-based helmet promotion program on knowledge, attitudes and practices of eligible adolescent drivers. Four public, four private and four vocational high schools situated in Attica, Greece, were sorted by type and randomly assigned to receive a 1-month intervention, based on the concepts of the Health Belief Model, or serve as controls. Self-report data were collected at baseline from 741 second grade students (∼16 years) and immediately after program completion. Linear mixed models with random student effects were used to estimate mean changes in scores for each treatment group and corresponding between groups differences of changes. Likelihood-based analysis showed that the intervention yielded a significant improvement in knowledge about helmet use. Yet, its impact on attitudes and practices appeared to vary across different school types. With current research offering ambiguous results on the appropriate timing of injury prevention efforts, this study suggests that educational programs targeting road safety can lead to positive changes if tailored to the needs of specific population groups and implemented during critical life periods, such as the transition to driving status. © The Author 2010. Published by Oxford University Press. All rights reserved

Sports injuries among children in six European union countries

Since sports participation entails the risk of injuries that account for substantial morbidity and disability, the existence of adequate epidemiological information is essential for the development of sound preventive strategies. In this study, we present data on the occurrence of sports injuries among children in six European countries, namely Austria, Denmark, France, Greece, The Netherlands, and the United Kingdom. An operational definition for sports injuries was developed, and comparable data from the European Home and Leisure Accident Surveillance System, an established injury surveillance system operating in 12 European union countries, were collected from the participating member states, during a 1-year period (1998). Sports injuries were examined in schools, in organised and unorganised settings, and in specific types of sports by demographics and injury descriptive variables. Sports injuries represent a quantitatively important and sufficiently serious problem in European union countries, accounting for an estimated annual number of about a quarter of a million outpatient visits in two of the participating countries, which provide national estimates. It is evident, that sport injuries are not only common but also injuries of considerable severity, since a large fraction represents fractures, while approximately 4% of the total require hospitalisation. Football and basketball among male children are, in declining order, the two sports responsible for the most frequent injuries in the European union countries, whereas gymnastics and volleyball prevail among females. The study indicates the importance of injury surveillance in describing the epidemiology of sports injuries and provides an estimate of the magnitude and the profile of sport injuries that take place annually in European union countries

The mosaic of equestrian-related injuries in Greece

Background: This study ainis to estimate the burden and describe the profile of equestrian injuries in Greece, where horses, donkeys, and mules are still used in agriculture and where horse riding is a popular leisure activity. Methods: Prospectively collected information on 140,823 injuries reported in the national Emergency Department Injury Surveillance System was examined and 244 equestrian-related injuries that occurred during farming, equestrian sports, or horse racing were analyzed. Results: The estimated countrywide injury incidence for farming and equestrian sports combined was 21 per 100,000 person-years, but it was 160 times higher for horse-racing personnel. Men had higher rates of racing injuries and women had higher rates of equestrian sport injuries. Fractures accounted for 39.0% of injuries in horse racing and 30.5% in farming; head injuries accounted for approximately 50% of injuries among farmers. Farming injuries were more serious, with 25% requiring hospitalization. Analysis through the Barell matrix pointed to the role of spurs in the causation of ankle fractures and dislocations and the likely contribution of helmets in preventing traumatic brain injuries. conclusion: Equestrian-related injuries are a serious but underappreciated health problem and merit targeted prevention efforts for each category affected

Estimating the population burden of injuries - A comparison of household surveys and emergency department surveillance

Background: Injuries represent an important public health problem but their incidence is difficult to estimate. Methods: We conducted a population-based household survey in Greece covering 4079 interviewed individuals. The interviewees reported, for themselves and for cohabitating adults (age 15 years and older; n = 7157), injuries that occurred during the preceding year. Major injuries were defined as those requiring contact with a health institution. We compared these survey data with data obtained through a national Emergency Department Injury Surveillance System (EDISS). Results: For the month closest to the survey interview, the incidence reported for the responders was 5.9 per 100 person-year, whereas the incidence for cohabitating adults was 3.7 per 100 person-years. These incidence rates declined for months more remote to the interview. Comparison of survey and EDISS data suggested that survey reporting was less accurate for nontraffic-related injuries. Taking into account possible recall and telescoping biases, the best survey estimate of the national annual number of major injuries is 525,000 (5.9 per 100 person-year), whereas the EDISS data yielded an estimate of 1,150,000 major injuries (12.9 per 100 person-years) Conclusions: Comparison of survey and EDISS data systems Provides quantitative assessment of accuracy of the survey data in relation to time of injury before report date, to severity of injury, and to whether the injury is to the interviewee or to a cohabitant. The 2 systems could be used in a complementary way, although EDISS generates information that is medically more accurate and is a more cost-effective data collection system

Is birth weight associated with childhood lymphoma? A meta-analysis

Several risk factors have been identified for childhood lymphomas. The purpose of this meta-analysis was to synthesize current evidence regarding the association between birth weight with primarily the risk for non-Hodgkin lymphoma (NHL), given its similarity to acute lymphoblastic leukemia, Hodgkin lymphoma (HL) and any category of lymphoma. Two cohort (278,751 children) and seven case-control studies (2,660 cases and 69,274 controls) were included. Effects estimates regarding NHL, HL and any lymphoma were appropriately pooled using fixed or random effects model in two separate analyses: specifically, high was compared to normal or any birth weight. Similarly, low was compared to normal or any birth weight. No statistically significant association was found between high birth weight, as compared to normal birth weight, and risk for NHL plus Burkitt lymphoma (OR = 1.17, 95% CI = 0.76-1.80, random effects), HL (OR = 0.94, 95% CI = 0.64-1.38, fixed effects) or any plus Burkitt lymphoma (OR = 1.09, 95% CI = 0.76-1.56, fixed effects). A null association emerged when low was compared with normal birth weight for NHL plus Burkitt lymphoma (OR = 1.07, 95% CI = 0.71-1.62, random effects), HL (OR = 0.94, 95% CI = 0.54-1.65, fixed effects) or any plus Burkitt lymphoma (OR = 1.02, 95% CI = 0.79-1.33, fixed effects). Accordingly, no association was found when high or low birth weight was compared to any birth weight. Although current evidence suggests no association, birth weight might be a too crude indicator to reveal a genuine association of fetal growth with specific lymphoma categories; hence, there is an emerging need for use of more elaborate proxies, at least those accounting for gestational week. Copyright © 2011 UICC

Leptin and body mass index in relation to endometrial cancer risk

Background/Aim: Because leptin is a hormone associated with obesity and reproduction, we attempted to examine whether there is a relationship between leptin and endometrial cancer. Methods: Cases were 84 women with histologically confirmed incident endometrial cancer, whereas controls were 84 women admitted to the same hospital for small surgical operations. The serum leptin levels were determined in fasting morning blood samples by using radioimmunoassay. The mean values of leptin levels among cases and controls were compared with simple t test, and the data were further analyzed using multiple logistic regression procedures. Results: The serum leptin levels were 36.7 +/- (SD) 25.7 ng/ml among cases and 26.9 +/- 19.8 ng/ml among controls (p = 0.006). After adjustment for known risk factors of endometrial cancer, components of the insulin-like growth factor system did not confound the association of leptin with endometrial cancer, but this association was eliminated, when the body mass index was adjusted for. Thus, the odds ratio for an increment of 1 SD of blood leptin was 1.52 (p = 0.03) before adjustment for body mass index, but only 1.13 (p = 0.62) after adjustment for it. Conclusions: In a case-control study of incident endometrial cancer in Greece, we found evidence that leptin is strongly positively associated with endometrial cancer. It cannot be conclusively inferred, however, whether leptin elevation, as a consequence of obesity, plays a role in endometrial carcinogenesis or whether it is a simple correlate of obesity. Copyright (C) 2002 S. Karger AG, Basel

A maternity hospital-based infant car-restraint loan scheme: Public health and economic evaluation of an intervention for the reduction of road traffic injuries

Aims: The results of an infant car-restraint loan scheme and evaluate its cost-effectiveness are presented. Methods: The intervention programme was initiated in 1996. Car-restraints, donated by manufacturers, were lent for a six-month period to eligible prospective parents for a modest fee. Specially trained health visitors performed in-person interviews with the participating parents. The data were collected and recorded on a pre-coded questionnaire. Cross-tabulations and multiple logistic regression were performed to analyse the data. Subsequent purchase of a next-stage car restraint, suitable for older children (up to four years of age) was considered as a proxy measure of the success of the programme. This information, along with the detailed operational and financial data collected during the implementation phase of the programme, was used to develop a model to assess the cost-effectiveness of a countrywide intervention. Results: During a two-year period 188 families participated in a survey. On return of the infant car restraint, 92% of the participants reported proper use of the device and 82% had already purchased the second-stage car restraint. Parental age, gender, or educational status was not predictive of positive parental road safety practices for the newly born, whereas history of parental seat-belt use - as a proxy of personal road safety behaviour - was positively correlated with the likelihood of purchasing a second-stage car-restraint device. The cost-effectiveness ratio varies between EURO 418.00 and EURO 3,225.00 per life-year saved, depending on whether the modest administrative fee is considered. Conclusions: On the basis of plausible assumptions, a loan programme of infant car-restraints was shown to be particularly cost effective

Correlation of nm23-H1 gene expression with clinical outcome in patients with advanced breast cancer

Journal URL: http://www.iiar-anticancer.org/main.php?id=