C. Hunchak

C. Meaney

L. Puchalski Ritchie

N. Meshkat

S. Teklu Waji

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204 Non -Commun i c a b l e D i s e a s e s & In j u r i e sand extended hospital stays. Non-serious complications includedformation of a hematoma, discoloration, oozing, swelling, or bleedingat the entry site. P values < 0.05 were considered significant.Results: An independent T-test indicated a significant (p < .001)increase in the mean percentage in the number of reused SUDs atBBH. There was no difference in the number of complications thatdeveloped after surgery between the hospitals, despite the significantdifference in the number of SUDs per procedure. When analyzinglength of stay, the results showed significant (p < .001) increase in theaverage mean stay for patients in BBH which may be attributed to theinitial health status of patients. No significant differences were foundbetween hospitals in the severity of complications was analyzed(serious vs. non-serious).Conclusion: There was no significant correlation between the reuseof single use medical devices and adverse outcomes for PTCA ateither of the two hospitals in which the study took place.Funding: No funding listed.Abstract #: 02NCD005Osteoporosis-Related knowledge, self-efficacy andhealth beliefs among Chinese women with breast cancerE. Hsieh1, Q. Wang2, X. Niu2, L. Fraenkel1, E. Bradley3, K. Insogna1,W. Xia4, J. Smith5, Y. Qiao6, P. Zhang2; 1Yale School of Medicine, NewHaven, CT/US, 2Cancer Institute and Hospital, Chinese Academy ofMedical Sciences, Beijing, CN, 3Yale School of Public Health & Grad-uate School of Arts and Sciences, New Haven, CT/US, 4Peking UnionMedical College Hospital, Beijing, CN, 5University of North CarolinaGillings School of Global Public Health, Chapel Hill, NC/US, 6NationalCancer Center, Cancer Hospital of Chinese Academy of Medical Sciences& Peking Union Medical College, Beijing, CNBackground: Women with breast cancer (BC) are at increased riskfor fracture, particularly in resource-limited settings where infrastruc-ture for osteoporosis screening and treatment is fragmented. Un-derstanding behavioral factors that influence adoption of fractureprevention measures in this population is critical. Utilizing conceptsfrom the Health Beliefs Model, we sought to evaluate osteoporosis-related knowledge, self-efficacy, and health beliefs among a cohort ofbreast cancer survivors in China.Methods: From April 2013- August 2014, BC survivors receivingcare at the Cancer Institute and Hospital of the Chinese Academy ofMedical Sciences were invited to participate in this cross-sectionalstudy. Women were eligible if they were 50-70 years of age, hadinitiated treatment for BC at least 5 years prior to enrollment, andhad no history of prior osteoporosis or metabolic bone disease.Volunteers completed a mandarin-language questionnaire thatincluded sociodemographic and fracture risk assessment, the Inter-national Physical Activity Questionnaire, a calcium and vitamin Dintake scale, the Osteoporosis Knowledge Test (OKT), OsteoporosisSelf-Efficacy Scale (OSES), and Osteoporosis Health Beliefs Scale(OHBS).Findings: 200 women were enrolled with a mean age of 57.54.9years, and BMI of 24.93.7 kg/m2. 78% of women had highschool level education or beyond. Smoking (ever; 3%) and alcoholuse (current; 5.5%) were rare. Rates of parental fracture history,personal fracture history, fall within the last year, and calciumsupplement use were 10.6%, 10.5%, 15.7%, and 51% respectively.53% engaged in high levels of physical activity and on averagewomen reported consuming calcium/vitamin D rich foods morethan once per week. Mean OKT score was 11.93.8 (scale: 0 to26). OSES scores (scales: 0 to 100) indicated greater confidenceregarding adopting dietary calcium intake behaviors (89.312.8)compared with exercise-related behaviors (66.815.2). OHBSscores (scales: 6 to 30) showed neutral levels of perceived suscepti-bility to (18.22.9) and seriousness of osteoporosis (20.13.3),high levels of health motivation (26.72.9), high perceived benefitto exercise and dietary calcium intake (25.93.6 and 23.63.3,respectively) and relatively low perceived barriers to these activities(14.03.9 and 14.03.5, respectively). Logistic regression adjustedfor age and BMI showed that high dietary calcium/vitamin D intakewas associated with fewer perceived barriers to dietary calciumintake (OR 0.84, 95%CI 0.77-0.93, p¼0.001), and high physicalactivity level was associated with fewer perceived barriers to exercise(OR 0.92, 95%CI 0.84-0.99, p¼0.04) and higher self-efficacy (1.02,95%CI 1.01-1.05, p¼0.02).Interpretation: Despite high risk for fracture, women in our studydemonstrated only moderate levels of knowledge regarding osteopo-rosis. Perceived barriers to dietary calcium intake and physical activity,as well as self-efficacy regarding physical activity may influence uptakeof these behaviors. Understanding these associations can aid devel-opment of targeted fracture prevention measures for women with BC.Funding: UJMT Fogarty Global Health FellowshipAbstract #: 02NCD006Patterns and predictors of early mortality in the TikurAnbessa hospital emergency department in AddisAbaba, Ethiopia: a prospective studyC. Hunchak1, S. Teklu Waji2, N. Meshkat3, C. Meaney4, L. PuchalskiRitchie5; 1Schwartz/Reisman Emergency Center and Emergency MedicineInstitute, Dept. of Family and Community Medicine, University of Tor-onto, Canada, Toronto, ON/CA, 2Addis Ababa University School ofMedicine, Department of Obstetrics & Gynecology and Emergency Med-icine, Addis Ababa, ET, 3Department of Medicine, University HealthNetwork, University of Toronto, Canada, Toronto, ON/CA, 4Departmentof Family and Community Medicine, University of Toronto, Canada,Toronto, ON/CA, 5University Health Network, Department of Medicine,University of Toronto, Canada, Toronto, ON/CABackground: Ethiopian emergency department (ED) patients have ahigh burden of illness and injury for which mortality rates have notbeen previously published. This study sought to characterize theburden of and to identify predictors for early ED mortality amongpatients presenting to the Tikur Anbessa Specialized Hospital ED(TASH-ED) in Ethiopia.Methods: Data was prospectively collected from the records of alladult (>¼15 yrs. of age) patients who died within 72 hours of EDadmission to the Tikur Anbessa Specialized Hospital in AddisAbaba, Ethiopia. Pearson’s chi-square and Fisher’s exact tests wereused to investigate associations between time to death and cause ofdeath in addition to demographic and clinical factors. Time from EDadmission to death was dichotomized as 0-6 hours and 6+ hours andlogistic regression was used to assess the adjusted impact of thesevariables on the probability of dying within 0-6 hours of ED admis-sion. This study was approved by the Research Ethics Boards at TikurAnbessa Hospital, Ethiopia and the University Health Network inToronto, Canada.Findings: Between October 2012 and May 2013, 16,056 patientsvisited the ED and 220 patients died within 72 hours of admission.After excluding patients dead on arrival (n¼34), the average age ofdeath was 43.1 years and the overall mortality rate was 1.2%. Headinjury (21.5%) and sepsis (18.8%) were the most common causes ofdeath. Relative to medical patients, trauma patients were youngerAnna l s o f G l o b a l He a l t h 205(p¼0.009), comprised more males (p¼0.05), died faster (<¼6 hours;p¼0.03), and were less likely to present during the day (p¼0.05). Thesole significant predictor of death within 6 hours was symptomduration less than 4 hours (4-48hrs vs. < 4hours: OR¼0.21, 95%CI¼0.08-0.54, p¼0.0014; >48 hours vs.Interpretation: The mortality burden of trauma and sepsis in theTASH-ED is high, and mortality patterns differ between these groups.As emergency medicine develops as a specialty in Ethiopia, reducedmortality among these otherwise young, previously well patients couldoccur through targeted trauma prevention advocacy and the devel-opment of context-specific ED clinical care protocols. The generaliz-ability of these study findings are limited by being a single-center studybut hold great importance for informed improvements in ED care atTikur Anbessa Hospital and likely approximate overall early EDmortality patterns in similarly-resourced ED settings in Ethiopia andother African countries.Funding: This project was funded by research grants from theUniversity Health Network and the International DevelopmentResearch Center.Abstract #: 02NCD007The road safety experiences and perspectives amongtechnology sector employees of a US multinationalcorporation in urban IndiaS.F. Jacoby1, F.K. Winston2, T.S. Richmond1; 1University of Pennsylva-nia, Philadelphia, PA/US, 2Center for Injury Research and Prevention,Children’s Hospital of Philadelphia, Philadelphia, PA/USBackground: There is urgent need for a multi-sectoral response toreduce the dangerously high road traffic injury and fatality rates inIndia. The purpose of this study was to understand the road useexperiences and perceptions of road safety and hazards among em-ployees of major multi-national corporation (MNC) in India toinform a globally enacted and locally-relevant employee road safetyplatform.Methods: Self-report surveys and focus group interviews were used toelicit the road safety perceptions, attitudes and behaviors of employeesin MNC’s offices in Bangalore and Pune. A convenience sample ofemployees was recruited through an office-wide email solicitation.Eligible participants: used a roadway to commute to work, were at least18 years old, and were proficient in written and spoken English.Approval was secured through the University of Pennsylvania Insti-tutional Review Board and participants provided written informedconsent. Six focus group interviews (lasting 1.5 hours) took place at 4differentMNC offices during daytime working hours. A research teammember used a focus group guide to elicit participants’ perspectivesabout traveling on roads in their city of residence, perception of roadsafety and hazards, experiences with road traffic injury, and opinionsabout programs that would enhance their self-efficacy as a road user.Study team members coded focus groups transcripts to develop cate-gories and themes that describe interview content. Focus group find-ings were interpreted within the context of the demographic, vehicularand road use features, and road safety behaviors, identified indescriptive analysis of survey data.Findings: Seventy-five employees (34 in Bangalore and 41 in Pune)participated in six focus groups. The demographic and road usevariables for both cities were comparable. The majority of partici-pants were 31-40 years of age, male, and used both personal 4-wheel and 2-wheel vehicles in daily road use. Participants consid-ered daily road use to be a dangerous and stressful experience.Roadway danger was attributed to vehicle mix, non-adherence totraffic laws, and local transportation infrastructure unequipped forthe rate of population and commercial growth. Comparing inter-view and survey data uncovered a mismatch between employeeknowledge of safety strategies and self-reported road safety attitudesand behaviors.Interpretation: Although the findings of this research cannot begeneralized beyond MNC employees in Bangalore and Pune, thisstudy illuminates an important public health role for MNCs withworkforces in high-risk road traffic environments. MNC employersshould target locally relevant policies and safety interventions whichacknowledge features of the local road traffic environment like poorinfrastructure and unenforced traffic law, as part of corporate healthpromotion platforms developed to decrease road traffic injury amongemployees.Funding: This material is based upon work supported by the NSFunder Grant No. 1243422 and NSF Center for Child Injury Pre-vention Studies.Abstract #: 02NCD008Differing rates of severe flame and electrical injury inseverely burned children from mexico and the unitedstatesG. Jensen1, S. Sen2; 1University of California Davis, Sacramento, CA/US, 2University of California Davis Medical Center, Sacramento, CA/USBackground: While scald burns are the most common burn inchildren in the United States (US), we hypothesized that flame andelectrical injuries, were more highly represented in patients fromMexico and would carry increased morbidity. The Shriners Hospitalfor Northern California (SHNC) receives transfers of pediatric burnpatients from Mexico, and provides an opportunity to assess theetiology of burns in children from separate countries in a commonenvironment.Methods: Retrospective data was reviewed on children ages 0-21years with burns involving total body surface area of burn injury(TBSA) of 20% or greater, admitted to SHNC from 2006-2014.Children admitted locally classified as being from the US. Pa-tients from Mexico were transferred from Mexico. Outcomesincluded mortality, TBSA, mechanism of injury, length of hos-pital stay (LOS), ventilator dependent time (VDT), number ofoperations required, and need for blood component resuscitation.Analysis was completed using R-statistical package (www.r-projec-t.org). All values are represented as mean standard deviation.Statistical significance was set for at p < 0.05. The study wasapproved by the institutional review board of the Shriners Hos-pital of Northern California.Findings: Over the period reviewed, 382 patients met entrycriteria, of which 66% were transferred from Mexico and 34% werefrom the U.S. Mean TBSA (3619% vs. 3423%, p¼0.4) andincidence of inhalation injury (21% vs. 16%, p¼0.29) did not differbetween Mexican and U.S. children. There was also no differencein overall LOS (p¼0.33), VDT (p¼0.78), number of operations(p¼0.18), or the amount of blood (p¼0.9) or FFP (p¼0.4) trans-fused. Compared to U.S. children, Mexican children had a signif-icantly higher incidence of flame injuries (62% vs 49%, p¼0.001)and accounted for a significantly higher incidence of electrical in-juries (6.7% vs. 0%, p¼0.0001). Patients from either country withflame or electrical burns had significantly higher TBSA (p¼<0.0001) and fresh frozen plasma in the ICU (p¼0.001) compared topatients with scald burn injuries. Intraoperative transfusion needs

Patterns and predictors of early mortality in the Tikur Anbessa hospital emergency department in Addis Ababa, Ethiopia: a prospective study

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Patterns and predictors of early mortality in the Tikur Anbessa hospital emergency department in Addis Ababa, Ethiopia: a prospective study

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