Cumulative incidence estimation in the presence of competing risks

When competing risks are present, the appropriate estimate of the failure probabilities is the cumulative incidence. stcompet creates new variables containing the estimate of this function, its standard error, and ln(−ln) transformed confidence bounds. Two examples are presented to illustrate the use of the new command and some key features of the cumulative incidence

Cumulative incidence estimation in the presence of competing risks

When competing risks are present, the appropriate estimate of the failure probabilities is the cumulative incidence. stcompet creates new variables containing the estimate of this function, its standard error, and ln(-ln) transformed confidence bounds. Two examples are presented to illustrate the use of the new command and some key features of the cumulative incidence. Copyright 2004 by StataCorp LP.stcompet, survival analysis, competing risks, cumulative incidence

Age-related safety in professional heavy vehicle drivers: a literature review

With Australia facing a looming shortage of heavy vehicle drivers the question is raised as to whether it is desirable or prudent to encourage older professional heavy vehicle drivers to remain in the transport sector for longer, particularly those of heavy vehicles or recruit drivers of a younger age. Aim: To review age-related safety and identify other factors that contribute to accidents experienced by heavy vehicle drivers. Methods: A search was conducted of national and international peer-reviewed literature in the following databases: MedLine, Embase, Cinahl, PsychInfo and the Canadian Centre for Occupational Health & Safety. A manual search was performed to obtain relevant articles within selected journals. Results: A limited number of studies reported age-specific accident rates for heavy vehicles for the spectrum of driver age that included drivers younger than 27 years and those over 60 years of age. Heavy vehicle drivers younger than 27 years of age demonstrated higher rates of accident/fatality involvement which decline and plateau until the age of 63 years where increased rates were again observed. Other contributing factors to heavy vehicle accidents include: long hours and subsequent sleepiness and fatigue, employer safety culture, vehicle configuration particularly multiple trailers, urbanisation and road classification. Conclusions: Drivers of heavy vehicles are over-involved until age 27 years however a characteristic ‘U’ shaped curve indicates a higher risk of accident involvement for both younger and older drivers. More detailed analyses of “at-fault” involvement and inability to avert an accident and other factors that contribute to accidents across the ages of heavy vehicle drivers may give further clarification to the degree of safety of both younger and older commercial heavy vehicle drivers

Improved injury management at an Australian aluminium smelter

Objective: This longitudinal study sought to determine the effectiveness of interventions to improve injury management in an industrial setting. Participants: Study participants were workers from three production departments of a large aluminium smelter. Methods: The interventions introduced were to encourage active participation in rehabilitation procedures by injured workers, improve communication with all stakeholders, identify and manage psychosocial issues, and focus the workforce on occupational health and safety matters. Linear regression modelling was used to determine the effectiveness of the interventions using data collected for fourteen months before and fifteen months after the introduction of interventions. Outcomes compared were the number of injuries, number of persons on restricted duty, and lost hours per month. Results: Modelling showed the intervention significantly reduced the number of injuries in the potrooms (from 14 to 6 per month). The number of persons on restricted duties was reduced in all departments (potrooms: from 12 to 7 persons per month, cast house: 3 to 1 person per month, carbon plant: 3 to 1 person per month). Lost hours were significantly reduced in the potrooms (from 244 to 61 hours per month). Conclusion: These findings demonstrate the effectiveness of the revised injury management process introduced

Nurses' sharps, including needlestick, injuries in public and private healthcare facilities in New South Wales, Australia

Background: The aim of this paper is to determine factors associated with sharps-related injury rates in nurses by analysing the combined data from two state-wide cross-sectional studies of nurses and comparing rates between public and private sectors and between different nurse practice areas in NSW. Methods: The data from two studies conducted in 2006 and 2007 were combined for 44 similar data items and for similar nurse participants (registered nurses, registered midwives and enrolled nurses). Both studies had recruited nurses from membership of the NSW Nurses' Association. Data for 256 and 1100 participants respectively were combined for this comparative analysis. Results: The sharps-related annual injury rate was 7.2% (95% CI: 5.9, 8.7). It was significantly higher in operating theatres, renal, mental health and paediatric practice areas in private compared with public facilities (17.9% versus 5.2%). Positive aspects of sharps safety practices included: 90% of nurses reported their injuries, were aware of processes required for dealing with sharps injuries and found their managers to be approachable. Areas for improvement included the provision of information about persons responsible for follow-up (21% unsure), increased provision of safety-engineered medical devices (SEMDs) (50% not available), decreased provision of non-SEMDs (75% available) and a focus on the highly-resistant practice of recapping needles (35% report recapping non-SEMDs). Conclusions: There are significant differences in sharps-related injuries between public and private facilities. Opportunities exist to improve safety practices across various nursing practice environments

An observed relationship between vestibular function and auditory thresholds in aircraft-maintenance workers

Objective: We sought to examine the vestibular function and whether an association exists between vestibular function and hearing thresholds in a group of military aircraft-maintenance workers with exposures to high levels of noise and organic solvents, relative to two different comparison groups. Methods: Vestibular function (using functional reach) and hearing (with pure-tone audiometry) were assessed in 601 exposed personnel, compared with two unexposed groups (500 technical trade and 391 nontrade). Results: Linear regression model showed that functional reach was slightly better for the comparison groups than the exposed group, with only one group being statistically significant, and there was a significant association between vestibular function and auditory thresholds at 500 and 1000 Hz. Conclusion: This study has demonstrated a relationship between low-frequency hearing loss, vestibular dysfunction, anxiety, and depression in an occupational population

Occupational exposures, smoking and airway inflammation in refractory asthma

The influence of occupation and ex/passive smoking on inflammatory phenotype is not well understood. The aim of this study was to examine the relationship between occupation, past smoking and current passive smoking and airway inflammation in a population of adults with refractory asthma. Methods: Sixty-six participants with refractory asthma were characterised. Occupational exposure to asthma causing or worsening agents were identified with an asthma-specific job exposure matrix. Exposure to passive cigarette smoke was determined by questionnaire and exhaled carbon monoxide assessment. The carbon content of macrophages was assessed in a sub-group of participants. Results: Nineteen participants had smoked previously with low smoking pack years (median 1.7 years). Ex-smokers more commonly lived with a current smoker (26% vs. 9%, p = 0.11) and were more likely to allow smoking inside their home (26% vs. 4%, p = 0.02) compared to never smokers. Twenty participants had occupations with an identified exposure risk to an asthmagen; thirteen had exposures to irritants such as motor vehicle exhaust and environmental tobacco smoke. Sputum neutrophils were elevated in participants with asthma who had occupational exposures, particularly those who were diagnosed with asthma at a more than 30 years of age. Conclusions: Sputum neutrophils are elevated in refractory asthma with exposure to occupational asthmagens. In addition to older age, exposure to both environmental and occupational particulate matter may contribute to the presence of neutrophilic asthma. This may help explain asthma heterogeneity and geographical variations in airway inflammatory phenotypes in asthma

Age related safety in professional drivers: final report

With Australia facing a looming shortage of heavy vehicle drivers the question is raised as to whether it is desirable or prudent to encourage older professional heavy vehicle drivers to remain in the transport sector for longer, particularly those of heavy vehicles or recruit drivers of a younger age. The objectives of this study are to: compare accident rates of younger and older heavy vehicle drivers relative to middle age drivers using data from the New South Wales Roads and Traffic Authority and the Australian Bureau of Statistics and to test for an interaction between vehicle type and controller age group for various other factors which may contribute to accident causation. Following a thorough analysis of all motor vehicle accidents where a vehicle was towed away, an injury or fatality occurred we conclude that the Australian Government initiative to diversify the working population to include older workers (> 65 years) is appropriate to the Australian transport industry, particularly heavy vehicle drivers following appropriate health surveillance. However this analysis has demonstrated that encouraging younger drivers (< 26 years), particularly to drive rigid trucks is also appropriate without this endangering workplace and road safety. We have demonstrated that for a number of important accident factors the age of the driver does not affect accident causation. This practice, with appropriate mentoring and training would lead to the creation of a more professional and skilled workforce. This research was funded under the WorkCover Assist Applied Research Program. The grantee, the Transport Workers Union (TWU) engaged the University of Newcastle to undertake the study. The conclusions in the final report are those of the authors and any views expressed are not necessarily those of WorkCover NSW

Commento conclusivo. Note in margine al First International Workshop Franco Soave on Hirschsprung disease and related neurocristopathies

Previous empirical evaluations of training programs aimed at improving dog adoption rates assume that dogs exhibiting certain behaviors are more adoptable. However, no systematic data are available to indicate that the spontaneous behavior of shelter dogs has an effect on adopter preference. The aim of the present study was to determine whether any behaviors that dogs exhibit spontaneously in the presence of potential adopters were associated with the dogs' length of stay in the shelter. A sample of 289 dogs was videotaped for 1 min daily throughout their stay at a county shelter. To account for differences in adopter behavior, experimenters varied from solitary passive observers to pairs of interactive observers. Dogs behaved more attentively to active observers. To account for adopter preference for morphology, dogs were divided into “morphologically preferred” and “non-preferred” groups. Morphologically preferred dogs were small, long coated, ratters, herders, and lap dogs. No theoretically significant differences in behavior were observed between the two different dog morphologies. When accounting for morphological preference, three behaviors were found to have a significant effect on length of stay in all dogs: leaning or rubbing on the enclosure wall (increased median length of stay by 30 days), facing away from the front of the enclosure (increased by 15 days), and standing (increased by 7 days). When combinations of behaviors were assessed, back and forth motion was found to predict a longer stay (increased by 24 days). No consistent behavioral changes were observed due to time spent at the shelter. These findings will allow shelters to focus behavioral modification efforts only on behaviors likely to influence adopters' choices